改良单切口多通道腹膜外机器人辅助腹腔镜前列腺根治性切除术（附120例报告）

doi:10.13418/j.issn.1001-165x.2022.6.21

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中国临床解剖学杂志 ›› 2022, Vol. 40 ›› Issue (6) : 743-747. DOI: 10.13418/j.issn.1001-165x.2022.6.21

临床研究

改良单切口多通道腹膜外机器人辅助腹腔镜前列腺根治性切除术（附120例报告）

陈正军，聂钰，卫义，周放，任尚青，范世达，吕倩，田景芝，王东*

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Modified single incision and multi-channel extraperitoneal robot-assisted laparoscopic radical prostatectomy (additional report of 120 cases)

Chen Zhengjun, Nie Yu, Wei Yi, Zhou Fang, Ren Shangqing, Fan Shida, Lv Qian, Tian Jingzhi, Wang Dong*

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摘要

目的探讨改良单切口多通道（无需使用多通道腹腔镜手术入路装置）腹膜外机器人辅助腹腔镜根治性前列腺切除术的疗效及安全性。方法回顾分析2020年11月至2021年6月四川省人民医院120例前列腺癌病人的临床资料。其中A组（改良单切口腹膜外途径）60例，B组（多切口经腹腔途径）60例。A组平均年龄67.5 （60~78）岁，其中，Gleason 评分≤7分50例，8分10 例。前列腺体积62.4(25.0~200.0) ml。B组平均年龄68.3 （57~80）岁，其中，Gleason 评分≤7分48例，8分12 例。前列腺体积63.2(29.5~120.0) ml。比较两组的手术时间、出血量、术后住院时间、术后通气时间、切缘阳性率、尿控满意率。结果两组患者手术均顺利完成。A组和B组术后通气时间分别为25 h（12 h~50 h）和81.5 h(48 h~160 h)，差异有统计学意义(P<0.05)。术后24 h、3个月、尿控满意率患者分别为20例(33.33%)、55例(91.67%)和6例(10.0%)、18例(30.0%),差异有统计学意义(P<0.05)。结论改良单切口多通道腹膜外机器人辅助腹腔镜根治性前列腺切除，术后尿控及肠道功能恢复快，不受特殊装置制约，易于普及。

Abstract

Objective To investigate the efficacy and safety of modified single incision multi-channel (There is no need to use a multi-channel laparoscopic surgical approach device) extraperitoneal robot-assisted laparoscopic radical prostatectomy. Methods The clinical data of 120 patients with prostate cancer in Sichuan Provincial People's Hospital from November 2020 to June 2021 were analyzed retrospectively. There were 60 cases in group A (modified single incision extraperitoneal approach) and 60 cases in group B (multi-incision transabdominal approach). The average age of group A was 67.5 (60~78) years old. Among them, Gleason score was ≤ 7 in 50 cases and 8 in 10 cases. The volume of prostate was 62.4 (25.0~200.0) ml. The average age of group B was 68.3 (57~80) years. Among them, Gleason score was ≤ 7 in 48 cases and 8 in 12 cases. The volume of prostate was 63.2 (29.5~120.0) ml. The operation time, blood loss, postoperative hospital stay, postoperative exhaust time, incisal margin positive rate and urine control satisfaction rate were compared between the two groups. Results The operation was completed successfully in both groups. The postoperative exhaust time in group A and group B were 25 h (12 h~50 h) and 81.5 h (48 h~160 h), respectively, with statistical difference (P<0.05). The satisfaction rate of urine control in 24 hours and 3 months after operation were 20 cases (accounting for 33.33%), 55 cases (accounting for 91.67%) and 6 cases (accounting for 10.0%), 18 cases (accounting for 30.0%) respectively, the differences were statistically significant (P<0.05). Conclusions Modified single incision and multi-channel extraperitoneal robot-assisted laparoscopic radical prostatectomy has good tumor control effect and rapid recovery of urinary continence and intestinal function after operation. It is not restricted by special PORT and is easy to be popularized.

导出引用

陈正军, 聂钰, 卫义, 周放, 任尚青, 范世达, 吕倩, 田景芝, 王东. 改良单切口多通道腹膜外机器人辅助腹腔镜前列腺根治性切除术（附120例报告）[J]. 中国临床解剖学杂志. 2022, 40(6): 743-747 https://doi.org/10.13418/j.issn.1001-165x.2022.6.21

Chen Zhengjun, Nie Yu, Wei Yi, Zhou Fang, Ren Shangqing, Fan Shida, Lv Qian, Tian Jingzhi, Wang Dong. Modified single incision and multi-channel extraperitoneal robot-assisted laparoscopic radical prostatectomy (additional report of 120 cases)[J]. Chinese Journal of Clinical Anatomy. 2022, 40(6): 743-747 https://doi.org/10.13418/j.issn.1001-165x.2022.6.21

中图分类号： R699.8 R737.25

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