Xu Ben, Peng Yi-Ji, Ma Guo-Zhong, Zhang Qian
Department of Urology, National Urological Cancer Center, Peking University First Hospital and Institute of Urology, Peking University, 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
Department of Urology, Affiliated Hospital of Heze Medical College, 777 Zhujiang Road, Mudan District, Heze City, 274000, Shandong, China.
World J Surg Oncol. 2020 Oct 27;18(1):279. doi: 10.1186/s12957-020-02051-y.
To introduce a novel "three-port" trocar placement technique for laparoscopic radical prostatectomy (LRP) in prostate cancer (PCa) patients.
We retrospectively reviewed 300 patients with PCa who received surgical treatment between November 2010 and June 2015 at our institution. They were divided into group A, three-port LRP; group B, conventional four-five-port LRP; group C, open RP (ORP); and group D, robotic-assisted RP (RARP). A learning curve was analyzed by dividing patients of group A into the early and late stages.
All groups were comparable with regard to the preoperative characteristics except for the relatively smaller prostate volume in group A. The three-port LRP operations were performed successfully with only 8 cases of conversion to the conventional LRP. None of any severe complications or conversion to ORP occurred. In group A, the mean operative time (OT) duration was 113.8 min, the mean estimated blood loss (EBL) was 94.2 ml, the mean drainage days was 4.0 days, the mean hospitalization was 5.1 days, and 27.8% of the prostate specimen margins (PSM) were positive. The differences of OT, EBL, drainage days, hospitalization, and transfusion in group A were statistically significant among the majority of the other groups (p < 0.05). After undergoing the early stages of a learning curve analysis in three-port LRP, the EBL was obviously decreased.
Three-port LRP is a novel technique that exhibits superior intraoperative advantages to the conventional LRP. Due to its less OT, EBL, drainage days, hospitalization, and transfusion with a shorter learning curve, it should be recommended and popularized in the clinical practice.
介绍一种用于前列腺癌（PCa）患者腹腔镜根治性前列腺切除术（LRP）的新型“三孔”套管针置入技术。
我们回顾性分析了2010年11月至2015年6月在我院接受手术治疗的300例PCa患者。他们被分为A组，三孔LRP；B组，传统四至五孔LRP；C组，开放根治性前列腺切除术（ORP）；D组，机器人辅助根治性前列腺切除术（RARP）。通过将A组患者分为早期和晚期来分析学习曲线。
除A组前列腺体积相对较小外，所有组术前特征均具有可比性。三孔LRP手术成功完成，仅8例转为传统LRP。未发生任何严重并发症或转为ORP的情况。A组的平均手术时间（OT）为113.8分钟，平均估计失血量（EBL）为94.2毫升，平均引流天数为4.0天，平均住院天数为5.1天，前列腺标本切缘（PSM）阳性率为27.8%。A组在OT、EBL、引流天数、住院时间和输血方面的差异在大多数其他组中具有统计学意义（p < 0.05）。在对三孔LRP进行学习曲线早期分析后，EBL明显下降。
三孔LRP是一种新技术，与传统LRP相比具有术中优势。由于其手术时间、EBL、引流天数、住院时间和输血量较少，学习曲线较短，应在临床实践中推荐并推广。
