摘要
目的:比较机器人辅助腹腔镜前列腺癌(PCa)根治术、传统腹腔镜PCa根治术治疗效果、术后尿控及安全性,旨在为PCa患者安全有效手术方案的制定提供参考.方法:以2018年7月至2019年1月本院收治的255例PCa患者为对象,根据非随机临床同期对照研究及患者自愿原则,将其分为腔镜组(传统腹腔镜PCa根治术,n=170)、机器人组(机器人辅助腹腔镜PCa根治术,n=85),对比两组手术操作时间、术中出血量、肠道功能恢复时间、术后住院时间及治疗费用,随访术后1、6、12个月两组尿控情况,并比较两组并发症发生率,术前、术后6、12个月采用前列腺癌专用问卷(EPIC)评估两组患者生存质量.结果:与腔镜组比较,机器人组手术操作时间、肠道功能恢复时间、术后住院时间明显短,术中出血量明显少,而治疗费用显著高(P<0.05);机器人组围手术期并发症总发生率明显低于腔镜组(P<0.05);术后1个月、6个月机器人组控尿率明显高于腔镜组(P<0.05),而术后12个月两组控尿率无明显差异(P>0.05);生存质量而言,机器人组术后6、12个月生存质量总评分明显高于腔镜组(P<0.05).结论:与传统腹腔镜PCa根治术比较,机器人辅助腹腔镜PCa根治术治疗PCa在促进患者康复进程、提高控尿率、改善预后及减少并发症发生方面有明显优势,但后者治疗费用更高.
Objective:To compare curative effect,postoperative urinary control and safety between prostate cancer(PCa)radical operation with da Vinci robot and laparoscopic PCa radical operation,and to provide reference for developing safe and effective surgical procedures for PCa patients.Methods:A total of 255 PCa patients who were admitted to the hospital from July 2018 to January 2019 were enrolled,and divided into laparoscopic group(laparoscopic PCa radical operation,n=170)and robot group(PCa radical operation with da Vinci robot,n=85).The operation time,intraoperative blood loss,recovery time of intestinal function,postoperative hospital stay and treatment cost were compared between the two groups.The urinary control status in both groups at 1 month,6 months and 12 months after surgery was followed up.The incidence of complications was compared between the two groups.Before surgery,at 6 months and 12 months after surgery,quality of life in both groups was evaluated by expanded prostate cancer index composite(EPIC).Results:Compared with laparoscopic group,operation time,recovery time of intestinal function and postoperative hospital stay were significantly shorter in robot group,intraoperative blood loss was significantly less,while treatment cost was significantly higher(P<0.05).At 1 month and 6 months after surgery,urinary control rate in robot group was significantly higher than that in laparoscopic group(P<0.05).At 12 months after surgery,there was no significant difference in urinary control rate between the two groups(P>0.05).At 6 months and 12 months after surgery,there were significant differences in quality of life scores between the two groups(P<0.05).At 6 months and 12 months after surgery,total score of quality of life in robot group was significantly higher than that in laparoscopic group(P<0.05).The incidence of complications in robot group was significantly lower than that in laparoscopic group(P<0.05).Conclusion:Compared with laparoscopic PCa radical operation,PCa radical operation with da Vinci robot in
作者
许婷
曹德宏
陈叶
余咿淼
XU Ting;CAO Dehong;CHEN Ye(Institute of Urology/Department of Urology,West China Hospital,Sichuan University,Sichuan Chengdu 610041,China)
出处
《河北医学》
CAS
2020年第7期1125-1130,共6页
Hebei Medicine
基金
四川省科技厅基金项目,(编号:2015SZ0230)。
