目的通过比较不同危险程度前列腺癌患者的治疗效果,分析腹腔镜前列腺癌根治术治疗高危前列腺癌患者的临床疗效及安全性。方法选取2008年1月至2011年1月进行前列腺癌根治术的患者85例,分为低、中、高危3组,对患者进行根治术并术后随访,比较3组患者的并发症及术后恢复情况。结果 3组患者术中并发症(包括大出血及直肠损伤)发生率及出血量差异无统计学意义(P均>0.05);3组患者术后并发症(包括切口感染、盆腔血肿、尿路感染、尿性腹水)发生率差异均无统计学意义(P均>0.05);低、中、高危3组患者切缘阳性率分别为5.6%、15.0%和33.3%,差异有统计学意义(P<0.05)。术后5年,低、中、高危3组完全控尿率分别为88.9%、78.4%、65.2%,差异有统计学意义(P<0.05);低、中、高危3组患者的性功能恢复率分别为66.7%、45.0%、33.3%,差异有统计学意义(P<0.05)。结论高危前列腺癌患者实施根治术的疗效虽不如低、中危患者,但其仍可到达较好的疗效,且安全性较好。 Objective To compare the clinical effects and safety of laparoscopic radical prostatectomy in the treatment of high-risk prostate cancer patients by comparing the therapeutic effect of different degrees of risk in patients with prostate cancer. Methods Totally 85 patients with radical prostatectomy from January 2008 to January 2011 were divided into three groups: low, medium and high risk group. The patients were treated with radical mastectomy and postoperative follow-up. Complications and complications of the three groups were compared After the recovery situation. Results There were no significant differences in the incidence of intraoperative complications (including major hemorrhage and rectal injury) and the amount of bleeding among the three groups (all P> 0.05). Postoperative complications (including incisional infection, pelvic hematoma, urinary tract infection , Urinary ascites) (P all> 0.05). The positive rates of the margins in low, medium and high risk groups were 5.6%, 15.0% and 33.3%, respectively, with significant difference (P <0.05). At 5 years after operation, the complete control of urine in 3 groups was 88.9%, 78.4% and 65.2%, respectively, with significant difference (P <0.05). The sexual function recovery in 3 groups was low, moderate and high The rates were 66.7%, 45.0% and 33.3%, respectively, with significant difference (P <0.05). Conclusions Although the curative effect of radical mastectomy in high-risk prostate cancer patients is not as good as that in low- and intermediate-risk patients, it still achieves better curative effect and better safety.