机器人辅助腹腔镜手术治疗前列腺癌的疗效观察
Observation on the therapeutic effect of robot assisted laparoscopic surgery for prostate cancer
陈潼 1刘健男 2冯强2
作者信息
- 1. 电子科技大学医学院,四川 成都 610054
- 2. 四川省医学科学院·四川省人民医院泌尿外科,四川 成都 610031
- 折叠
摘要
目的 探讨前列腺癌患者腹腔镜手术时辅助应用机器人对患者疗效影响.方法 回顾性分析 2021 年 1 月至2022 年12 月我院收治的154 例前列腺癌腹腔镜手术患者,依据手术方式不同分为机器人辅助组(n=84)与腹腔镜手术组(n= 70).比较两组患者围术期指标,手术前后尿动力学指标与国际前列腺症状评分(IPSS)、国际勃起功能指数问卷表-5(IIEF-5)评分,术后1 年生化复发、阳性切缘以及尿控率,术后并发症发生情况.结果 机器人辅助组患者手术时间、出血量、尿管留置时间、肠胃功能恢复时间、术后住院时间均明显少于腹腔镜手术组患者(P<0.05);机器人辅助组患者术前术后最大尿流率(Qmax)、充盈期膀胱顺应性值(BC)、最大尿流率时逼尿肌压力(Pdetat Qmax)、残余尿量值(PCR)、IPSS评分差值大于腹腔镜手术组,且术后逼尿肌不稳定(DI)发生率、IIEF-5 评分均优于腹腔镜手术组(P<0.05);两组生化复发率、尿控率比较差异无统计学意义(P>0.05);机器人辅助组术后并发症发生率显著低于腹腔镜手术组(P<0.05).结论 机器人辅助腹腔镜手术治疗前列腺癌疗效较好,同时在改善围术期指标以及减少术后并发症方面优势显著.
Abstract
Objective To explore the impact of robot assisted application on the efficacy of laparoscopic surgery for patients with prostate cancer.Methods Data of 154 patients with prostate cancer who underwent laparoscopic surgery in our hospital from January 2021 to December 2022 were retrospectively analyzed.The patients were divided into a robot-assisted group(n=84)and a laparoscopic surgery group(n=70).Perioperative indicators,urodynamic indicators,International Prostate Symptom Score(IPSS)and International Index of Erectile Function(IIEF-5)scores before and after surgery,biochemical recurrence,positive margin and urinary control rate after 1 year of surgery and occurrence of postoperative complications were compared between the two groups.Results Operation time,blood loss,catheter indwelling time,recovery time of gastrointestinal function,and length of postoperative hospital stay in the robot-assisted group were significantly shorter/less than those in the laparoscopic surgery group(P<0.05).The differences in maximum urinary flow rate(Qmax),bladder compliance(BC)value,detrusor pressure at maximum urinary flow rate(Pdetat Qmax),post-void residual urine(PVR)and IPSS score of the robot-assisted group before and after surgery were all greater than those in the laparoscopic surgery group.The incidence of postoperative detrusor instability(DI)and IIEF-5 score of the robot-assisted group were better than those in the laparoscopic surgery group(P<0.05).The biochemical recurrence rates and urinary control rates in the two groups were comparable(P>0.05).The incidence of postoperative complications in the robot-assisted group was significantly lower than that in the laparoscopic surgery group(P<0.05).Conclusions Robot assisted laparoscopic surgery has a good therapeutic effect on prostate cancer.It also has significant advantages in the improvement of perioperative indicators and the reduction of postoperative complications.
关键词
机器人/腹腔镜手术/前列腺癌/疗效Key words
Robot/Laparoscopic surgery/Prostate cancer/Therapeutic effect引用本文复制引用
基金项目
四川省科技厅重点研发项目(2021YFS0384)
出版年
2024
NETL
NSTL
万方数据