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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

24卷

期数:

2018年04期

页码:

312-314

栏目:

出版日期:

2018-07-20

文章信息/Info

Title:

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作者:

张 新¹; 杨永姣¹; 2; 刘 莉²; 陈业刚¹; 2; 程天木¹; 陈延航¹; 刘晓强¹; 2

1.天津医科大学第二医院泌尿外科，天津 300211；2.天津市泌尿外科研究所，天津300211

Author(s):

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关键词:

经直肠前列腺穿刺活检术; 经会阴前列腺穿刺活检术; 围术期; 腹腔镜下前列腺癌根治术

Keywords:

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分类号:

R737.25

DOI:

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文献标志码:

Ａ

摘要:

目的：比较经直肠径路与经会阴径路前列腺穿刺活检后，对行腹腔镜下前列腺癌根治术围术期的影响。方法：回顾性分析行一种方式穿刺确诊为前列腺癌，行腹腔镜下前列腺癌根治术患者137例，其中经直肠径路98例，经会阴径路39例，经会阴径路平均穿刺针数为28针。评估患者穿刺后行根治手术的间隔时间、术中粘连程度、手术时间、术中出血量、切缘阳性率、术后住院天数、术后Gleason评分（GS）变化。结果：所有患者均成功接受手术，前列腺与直肠粘连较为严重经直肠组为44（44.9%）例，经会阴组7（17.9%）例（P＜0.05），平均手术时间经直肠组（191±10） min，经会阴组（199±15） min（P＜0.05），平均术中出血量经直肠组（289±55） mL，经会阴组（199±15） mL（P＜0.05），手术切缘阳性经直肠组16（16.3%）例，经会阴组7（17.9%）例（P＜0.05），根治术后Gleason评分一致性方面，经直肠组50（51.0%）例，经会阴组22（56.4%）例（P＜0.05），术后Gleason评分增加经直肠组39例（39.8%），经会阴组8例（20.5%）（P＜0.05）。平均间隔时间经直肠组（51±15） d，经会阴组（２0±10） ｄ（P＞0.05），中位术后住院天数经直肠组12 d，经会阴组10 d（P＞0.05）。结论：两种入路穿刺活检后对行腹腔镜下前列腺癌根治术围术期影响较大，经会阴入路优于经直肠入路，经直肠穿刺后患者再行根治性手术有更高的病理进展风险，需谨慎选择合适的人群。

Abstract:

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参考文献/References:

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更新日期/Last Update: 2018-07-20