[1]李扬 朱汝健** 张裕庆 方恺 梁胜杰 刘东 伊庆同 顾建军 胡巍 龚旻.三孔法与四孔法经腹膜外途径腹腔镜前列腺癌根治术：前瞻性随机对照研究[J].中国微创外科杂志,2020,01(11):961-965.
　Li Yang,Zhu Rujian,Zhang Yuqing,et al.Threeport and Fourport Laparoscopic Extraperitoneal Radical Prostatectomy：Prospective Randomized Controlled Trial[J].Chinese Journal of Minimally Invasive Surgery,2020,01(11):961-965.
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三孔法与四孔法经腹膜外途径腹腔镜前列腺癌根治术：前瞻性随机对照研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2020年11期
页码:
961-965
栏目:
临床论著
出版日期:
2020-11-25

文章信息/Info

Title:
Threeport and Fourport Laparoscopic Extraperitoneal Radical Prostatectomy：Prospective Randomized Controlled Trial
作者:
李扬 朱汝健** 张裕庆 方恺 梁胜杰 刘东 伊庆同 顾建军 胡巍 龚旻
（上海市浦东医院复旦大学附属浦东医院泌尿外科，上海201399）
Author(s):
Li Yang;  Zhu Rujian;  Zhang Yuqing;  et al.
Department of Urology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai 201399, China
关键词:
前列腺癌; 腹腔镜前列腺癌根治术; 三孔法; 四孔法
Keywords:
Prostate cancer; Laparoscopic radical prostatectomy; Threeport method; Fourport method
文献标志码:
A
摘要:
目的探讨三孔法与四孔法经腹膜外途径腹腔镜前列腺癌根治术（extraperitoneal laparoscopic radical prostatectomy，ELRP）的临床疗效。方法2017年5月~2019年1月80例前列腺癌随机分为三孔法组和四孔法组，每组40例，均由同一术者完成ELRP，比较2组患者围手术期临床指标、术后生化复发率、术后尿失禁发生率等指标。结果三孔法组手术时间明显少于四孔法组［（1204±220）min vs(1405±237)min，t=-3932，P=0000］，术中出血量明显少于四孔法组［（1064±209）ml vs（1241±200）ml，t=-3880，P=0000］，术后引流管留置时间明显短于四孔法组［（40±13）d vs（47±17）d，t=-2044，P=0045］，术后导尿管留置时间明显短于四孔法组［（71±14）d vs（81±20）d，t=-2426，P=0018］，术后住院时间明显短于四孔法组［（74±11）d vs（80±12）d，t=-2135，P=0036］。三孔法组与四孔法组术后切缘阳性分别为7、10例，差异无显著性（χ2=0672，P=0412）。三孔法组与四孔法组患者术后3、6、12个月尿失禁发生率和1年生化复发率差异均无显著性（χ2=0136，P=0713； χ2=0534，P=0465； χ2=0402，P=0526； χ2=0289，P=0591）。结论与四孔法相比，三孔法ELRP是一种安全有效的手术方式，在缩短手术时间、减少术中出血、缩短术后康复时间等方面更有优势，值得临床推广。
Abstract:
ObjectiveTo compare the clinical efficacy of threeport laparoscopic extraperitoneal radical prostatectomy with fourport laparoscopic prostatectomy. MethodsA total of 80 patients with prostate cancer admitted to our hospital from May 2017 to January 2019 were selected. According to the randomized control table, they were divided into threetrocar group and fourtrocar group, with 40 cases in each group. Threetrocar and fourtrocar laparoscopic extraperitoneal radical prostatectomy were performed by the same surgeon. The perioperative clinical data,postoperative biochemical recurrence rate, urinary incontinence rate and positive rate of incision margin were compared between the two groups.ResultsThe operation time of the threetrocar group was significantly less than that of the fourtrocar group ［(120.4±22.0)min vs. (140.5±23.7)min, t=-3.932, P=0.000］; the blood loss of the threetrocar group was significantly less than that of the fourtrocar group ［(106.4±20.9)ml vs. (124.1±20.0)ml, t=-3.880, P=0000］. The indwelling time of the drainage catheter in the threetrocar group was less than that of the fourtrocar group ［(4.0±1.3) d vs. (4.7±1.7)d, t=-2.044, P=0.045］. The indwelling time of the catheter in the threetrocar group was less than that in the fourtrocar group ［(7.1±1.4)d vs. (8.1±2.0)d, t=-2.426, P=0.018］. The patients in the threetrocar group were less hospitalized than the fourtrocar group ［(7.4±1.1)d vs. (8.0±1.2)d, t=-2.135, P=0.036］. The number of positive resection margins was 7 and 10 cases, respectively (χ2=0.672, P=0.412). There was no significant difference between the threetrocar group and the fourtrocar group in the urinary incontinence rate at 3, 6, and 12 months after surgery and 1year biochemical recurrence rate (χ2=0.136, P=0.713; χ2=0.534, P=0.465; χ2=0.402, P=0.526; χ2=0.289, P=0.591).ConclusionCompared with the fourport method, the threeport laparoscopic extraperitoneal radical prostatectomy is a safe and effective method, which has more advantages in shortening the operation time, reducing intraoperative bleeding, and shortening the recovery time, being worthy of clinical promotion.

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备注/Memo

备注/Memo:
基金项目：上海市卫生和计划生育委员会科研课题项目（201740292）；上海市浦东新区卫生系统重点学科建设（PWZxk2017-21）**通讯作者，Email：tzzhurj@163.com
更新日期/Last Update: 2021-02-07