Phinthusophon Kittipong, Nualyong Chaiyong, Srinualnad Sittiporn, Taweemonkongsap Tawatchai, Amornvesukij Teerapon
Division of Urology, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2007 Dec;90(12):2644-50.
To compare the perioperative results between Transperitoneal Laparoscopic Radical Prostatectomy (T-LRP) and Extraperitoneal Endoscopic Radical Prostatectomy (E-LRP).
Retrospective reviews of 125 patients who underwent laparoscopic radical prostatectomy by single surgeon (C.N) for stage T2-T3 adenocarcinoma of the prostate between May 2001 and July 2006 at Siriraj Hospital. Fifty-six cases had T-LRP and 69 cases had E-LRP The preoperative data (age, presenting PSA, and Gleason score), perioperative data (prostatic weight, operative time, intraoperative blood loss, the day of full oral diet, length of drain, and catheter time), pathologic stage, and margin status were compared.
Mean age and Gleason score were comparable in both groups. Mean presenting PSA was lower in T-LRP (9.93) as compared to E-LRP (21.84) (p = 0.046). The mean prostatic weight was comparable in both T-LRP and E-LRP. The mean operative time of T-LRP (350) was significant longer than E-LRP (220) (p < 0.001). Mean intraoperative blood loss was more in T-LRP (883) as compared to E-LRP (605) (p = 0.001). Average blood transfusion was higher in T-LRP (1.23 unit) as compared to E-LRP (0.32). Postoperative full oral diet, length of drain, and catheter time in E-LRP were shorter than T-LRP (full diet: median 2 days vs. 3 days, p = 0.001) (length of drain: 4.98 days vs. 6.69 days, p = 0.002) (Catheter time: 8.9 days vs. 11.9 days, p = 0.002). Margin status were comparable in both groups but mean postoperative Gleason score was higher in E-LRP as compared to T-LRP (7.2 vs. 6.85, p = 0.022).
E-LRP resulted in significant less operative time, intraoperative blood loss, postoperative oral diet, length of drain and catheter time where as the pathological margin status was the same in both T-LRP and E-LRP.
比较经腹腔腹腔镜前列腺癌根治术（T-LRP）与腹膜外腔镜前列腺癌根治术（E-LRP）的围手术期结果。
回顾性分析2001年5月至2006年7月在诗里拉吉医院由同一外科医生（C.N）为T2-T3期前列腺腺癌患者实施腹腔镜前列腺癌根治术的125例患者。其中56例行T-LRP，69例行E-LRP。比较术前数据（年龄、初始前列腺特异抗原[PSA]水平和Gleason评分）、围手术期数据（前列腺重量、手术时间、术中失血量、开始正常饮食时间、引流管留置时间和导尿管留置时间）、病理分期及切缘情况。
两组患者的平均年龄和Gleason评分相当。T-LRP组的平均初始PSA水平（9.93）低于E-LRP组（21.84）（p = 0.046）。T-LRP组和E-LRP组的平均前列腺重量相当。T-LRP组的平均手术时间（350分钟）显著长于E-LRP组（220分钟）（p < 0.001）。T-LRP组的平均术中失血量（883毫升）多于E-LRP组（605毫升）（p = 0.001）。T-LRP组的平均输血量（1.23单位）高于E-LRP组（0.32单位）。E-LRP组术后开始正常饮食时间、引流管留置时间和导尿管留置时间均短于T-LRP组（开始正常饮食时间：中位数2天对3天，p = 0.001）（引流管留置时间：4.98天对6.69天，p = 0.002）（导尿管留置时间：8.9天对11.9天，p = 0.002）。两组切缘情况相当，但E-LRP组术后平均Gleason评分高于T-LRP组（7.2对6.85，p = 0.022）。
E-LRP的手术时间、术中失血量、术后开始正常饮食时间、引流管留置时间和导尿管留置时间显著减少，而T-LRP和E-LRP的病理切缘情况相同。
