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目的:探讨机器人辅助腹腔镜手术在高危前列腺癌中的临床应用。方法:回顾性分析2015年3月~2016年9月采用机器人辅助腹腔镜下根治性前列腺切除术(RALP)治疗高危前列腺癌的临床资料。结果:43例手术均顺利完成,无中转开放,平均手术时间(288.05±87.75)min,术中出血量(277.69±402.67)ml,术后3d总的引流量为(431.58±346.75)ml;肠道功能恢复时间为(3.05±1.33)d。术后淋巴瘘3例、尿瘘2例、皮下出血1例,均保守治疗后好转。尿管于术后2周左右拔除,术后住院4~39d,平均(12.56±6.47)d。术后随访6周~15个月,生化复发3例,无完全性尿失禁患者。结论:RALP治疗高危前列腺癌是一种安全、有效的方法,短期效果良好,尤其在功能保存和重建方面具有明显优势。
Objective: To investigate the clinical application of robot-assisted laparoscopic surgery in high-risk prostate cancer. Methods: The clinical data of robotic assisted laparoscopic radical prostatectomy (RALP) in the treatment of high-risk prostate cancer from March 2015 to September 2016 were retrospectively analyzed. Results: The operation of 43 cases was successfully completed and the mean operation time was (288.05 ± 87.75) min, the intraoperative blood loss was 277.69 ± 402.67 ml, and the total drainage volume was (431.58 ± 346.75) ml Road function recovery time was (3.05 ± 1.33) d. 3 cases of postoperative lymphatic fistula, 2 cases of urinary fistula, 1 case of subcutaneous hemorrhage, were improved after conservative treatment. The catheter was removed at about 2 weeks after operation and was hospitalized for 4 to 39 days (mean, 12.56 ± 6.47 days). All the patients were followed up for 6 weeks to 15 months with 3 biochemical recurrences without complete urinary incontinence. Conclusions: RALP is a safe and effective method for the treatment of high-risk prostate cancer. The short-term effect is good, especially for functional preservation and reconstruction.