| Objective:By comparing the Clinical effect of extraperitoneal laparoscopic radical prostatectomy(ELRP)in the patients with low-risk and intermediate-risk prostate cancer and in the patients with localised high-risk prostate cancer(HRPC),to explore the safety and clinical value of extraperitoneal laparoscopic radical prostatectomy for localised high-risk prostate cancer.Methods:The clinical data of 72 patients with prostate cancer who underwent extraperitoneal laparoscopic radical prostatectomy from September 2014 to August 2017 in the second affiliated hospital of kunming medical university were analyzed retrospectively.All of the patients were localized prostate cancer.According to the D'amico grading standard,72 patients were divided into low-risk(LRPC)and intermediate-risk patients(IRPC)group and Localised high-risk patients(HRPC).Preoperatively all patients were diagnosed as prostate cancer by transurethral resection of prostate(TURP)or prostate biopsy.Respectively observe the index of correlation of the two groups,including patients age,preoperative PSA,operative time,intraoperative blood loss,blood transfusion percentage,postoperative hospitalization days,positive surgical margins,pathological score,catheter retention time,urinary continence rate,periprocedural complications,biochemical recurrence and so on.Results:27 patients were included in LRPC and IRPC patients groups with an average age of 67.3±5.8 and the average prostate volume of 39.1±18.3cm3,as well as 45 patients in LHRPC group with an average age of 68.2±5.9 and the average prostate volume of 45.5±21.9cm3.There was no statistical significance and the two groups were comparable(P>0.05).The preoperative average PSA level was 13.5±10.5ng/ml and 43.6±34ng/ml respectively and the Gleason score was 6.5±0.8 and 8.6±0.8 respectively,which were of statistical difference between the two groups(P<0.05).The operation time was 166.1 ±73.4min and 171.1 ±65.1min respectively,the intraoperative blood loss was 174.1 ±74.5ml and 197.6±82.4ml respectively,the blood transfusion percentage was 3.7%?4.4%,the catheter retention time was 19.1±5.4d and 18.5±4.4d,the retroperitoneal drainage tube retention time was 13.7±7.5d and 14.2±7.8d,the postoperative hospitalization days was 10.8±4.1d and 11.6±4.3d,urine leakage rate was 7.4%and 13.3%.None of the above differences were statistically significant(P>0.05).3 months urinary continence rate was 81.5%and 77.8%,6 months urinary continence rate was 92.6%?91.1%,and 12 months urinary continence rate was 96.3%,95.6%,which were not statistically different.The LHRPC patients group was of higher postive surgical margins rate(22.2%VS 3.7%)and biochemical recurrence rate(26.7%VS 3.7%),which were of statistica difference(P<0.05).The periprocedural complications rate was 11.1%and 20%,which were not of significant difference(P>0.05).Conclusion:Extraperitoneal laparoscopic radical prostatectomy has an advantage in the treatment of localized high-risk prostate cancer.It can further clarify pathological stage to guide the next step of treatment.In the treatment of localized high-risk patients also has better clinical curative effect,especially in the short-term effect is good.As well as,the long-term follow-up is needed to confirm the further effect. |
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