The Clinical Analysis Of Extraperitoneal Laparoscopic Radical Prostatectomy After Previoes Transurethral Resection Of Prostate

Objective:To investigate the effects of extraperitoneal laparoscopic radical prostatectomy(ELRP)after previoes transurethral resection of prostate(TURP).Method:A retrospective analysis was performed on 48 patients with prostate cancer admitted to our hospital from August 2015 to December 2018,all of them underwent ELRP surgery.According to the preoperative history of TURP surgery,the patients were divided into group A(21 patients with TURP surgery history)and group B(27 patients without TURP surgery history).The intraoperative,postoperative and follow-up conditions were observed,and the operation time,blood loss,blood transfusion proportion,indwelling catheter time,indwelling drainage tube time,postoperative hospitalization days,positive rate of incisal edge and other indicators of the two groups were compared.Results:All the 48 cases were successfully completed without conversion to laparotomy.The average age of group A was 67.9±5.7 years,and that of group B was 67.3±5.8 years.The average operative time of group A and group B was(272.9±76.7)min,(243.9±58.1)min,and the average intraoperative blood loss was(330.4±330.5)ml,(182.9±132.1)ml,respectively.The proportion of blood transfusions was 4.8%and 7.4%.The positive rate of incisal edge was 4.8%and 7.4%.Catheter indwelling time:(12.4±1.8)d,(10.5±1.9)d;Indwelling time of drainage tube:(8.1±1.2)d,(6.6±1.9)d;Postoperative hospitalization days:(15.4±5.6)d,(12.1±3.2)d.The follow-up time was(16.0±10.6)months,with the longest being 41 months.All the 48 patients survived.The biochemical recurrence rates of group A and B were 4.8%and 7.4%respectively.The rate of urinary control was 66.6%and 66.7%3 months after operation.The rate of urinary control was 90.4%and 92.6%6 months after operation.The rate of urinary control was 95.2%and 96.3%1 year after operation.Conclusion:Although TURP will increase the difficulty of ELRP,ELRP is safe and feasible,and can provide a basis for further comprehensive treatment after surgery,so as to further improve the survival rate of patients,which has clinical application value.For the patients who has TURP surgery history to decrease the difficulty of operation ELRP,cystoscopy was performed before ELRP,360° cutting in bladder neck incision,only as deep as muscular layer completes the bladder neck,ureteral opening tags,don't have to cut through the bladder.To reduce edema of prostate tissue,the operation opportunity surgery is recommended 3 months after TURP surgery.