| ObjectiveDa Vinci robot-assisted laparoscopic radical prostatectomy(RALRP)was introduced to explore the clinical therapeutic effect and future application.MethodsBack in General Hospital of Jinan Military for treatment of the clinical data of 19 cases of parallel robot Da Vinci assisted laparoscopic radical resection in patients with prostate cancer from September 2012 to March 2016.The patient's age ranged from 51 to 79 years,with an average(68.79 + 7.68)years old.preoperative examination of PSA which is less than or equal to 10ng/ml in 8 cases,10 to 20ng/ml in 7cases,4 cases was larger than 20ng/ml.All patients with preoperative diagnosis of prostate cancer in 18 cases prostate biopsy diagnosis,including 15 cases of puncture biopsy to see cancer tissue,3 cases of benign prostatic hyperplasia,1 cases were confirmed after transurethral resection of prostate(TURP).Gleason score < 7 = 7 points in 2 cases,10 cases,more than 7 points in 3 cases.bone metastases were found in all of the whole body bone imaging in 1 cases.There were 1 cases of lymph node metastasis in prostate magnetic resonance imaging,and 18 cases had no lymph node metastasis.Among them,15 cases were clinically early localized prostate cancer,3 cases were combined with clinical and auxiliary examination.All patients were feasible to Da Vinci robot assisted laparoscopic radical prostatectomy,including 1 cases of bilateral pelvic lymph node dissection.ResultsAll operations were performed by Da Vinci robotic assisted laparoscopic surgery,none of the cases were converted to conventional laparoscopic or open surgery.None of the patients suffered from carbon dioxide poisoning and cerebral hemorrhage.operation time ranged from 180 to 330 min,(240.52 ± 33.99)min on average;intraoperative hemorrhage 100 to 900 ml,average(290.26 ± 18.15)ml,1 cases intraoperative transfusion 400 ml.Postoperative 4 to 7 days out of bed activities average(5.32 ±3.53)d;postoperative hospital stay was 10 to 21 days,average(15.2 ±2.07)d;14 to30 d extraction catheter average(15.21 ± 2.40)d.Postoperative leakage of urine in 2 cases,leakage of urine in postoperative 7d stopped.No lymphatic fistula after surgery.Pathological margin was positive in 3 cases,seminal vesicle in 2 cases,lymph node metastasis in 1 cases.1to12 months after surgery,PSA < 0.2ng/ml patients 12 cases,PSA>0.2ng/ml,7 cases of patients,postoperative endocrine therapy.After 1 to 3 months,there were 3 patients with varying degrees of urinary incontinence,and the patients with urinary incontinence now relieved and did not interfere with the normal life.ConclusionsIn our country,the incidence of prostate cancer is low,but the incidence of prostate cancer is increasing year by year,and the incidence of malignant tumors in the elderly over 70 years old is the first.With the development of prostate specific antigen(PSA)screening,more and more prostate cancer can be detected in the early stage.Patients with the hope of a cure,Da Vinci robotic assisted laparoscopic radical prostatectomy is one of the most effective methods for the treatment of early localized prostate cancer.The operation can completely remove the tumor,achieve the purpose of curative effect,and is easy to be accepted by the patients.With the development of science and technology,more and more sophisticated surgical instruments,the operation of skilled operators,postoperative complications.In patients with no obvious contraindications to surgery and economic conditions permit under,Da Vinci robotic assisted laparoscopic prostate cancer radical surgery.The operation can shorten the period of hospitalization,reduce the pain and reduce the chance of infection and so on.For the operation,the operation can not only increase the fine degree of operation,but also reduce the operation fatigue,and it is worth popularizing.Even patients can increase the incidence of prostate cancer after 70 years of age,you can routinely perform Da Vinci robot-assisted laparoscopic radical prostatectomy. |
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