To Compare The Therapeutic Effect In Sequential Under Way By The Time Of The Extraperitoneal Laparoscopic Radical Prostatectomy For Prostate Cancer

Purpose:To analyze and summarize experience and efficacy of theextraperitoneal approach to laparoscopic radical prostatectomy.Medthods: Retrospective analysis in May2009to October2011to completethe same performer of the extraperitoneal laparoscopic radical prostatectomymedical records of patients, a total of34cases. By operation datesuccessively, grouping the first12cases (group1), then11patients (group2)and the last11patients (group3), compare operation time, peri-operativebleeding and postoperative indwelling catheter time, postoperativehospitalization time, postoperative drainage tube time after the lien, operationcut edge positive and suspicious and complications of positive as indexes.Results: Surgery have been successful.1,2,3groups average operation time±standard deviation for respectively for (394.6±108.5) min,(240.9±42.3)min,(171.8±19.4) min.1,2,3groups average peri-operative bleeding±standard deviation for respectively (404.2±353.2)ml,(336.4±272.1) ml,(177.3±114.8) ml. Total blood transfusion rate was11.7%,1,2,3groups were25%,9%and0%. Again the operation rate is zero.1,2,3groups a mean ofbladder indwelling catheter±standard deviation for time, respectively (16.8±2.7)d,(17.6±5.2) d,(14.4±0.5)d.1,2,3groups a mean±standarddeviation for time, respectively (18.3±3.8)d,(15.1±8.6)d,(7.7±1.1) d.1,2,3groups a mean after the indwelling catheter±standard deviation fortime,respectively (12.4±6.0)d,(11.1±7.0) d,(6.6±1.3)d. Operation cutedge positive and suspicious positive rate was20.6%(7/34), tumours pT3bstaging the5cases (2cases of positive,3cases suspicious positive), the pT3a2cases see suspicious positive operation cut edge. Postoperative anastomotic leakage in7patients, of whom1,2,3groups were for3cases,3cases, in1.28cases were obtained for postoperative follow-up time4~33months, onaverage,15months. After3months of21cases of PSA are dropped to0.2ng/ml below. By the date of follow-up, there are5cases of biochemicalrecurrence,2cases of whole body transfer (1cases bone metastases,1caseof retroperitoneal lymph node metastasis and the bone).28patients and27cases after urethral catheter withdraw can control micturition,1case after oneyear still incontinence.Conclusions: Extraperitoneal laparoscopic radical prostatectomy is treatedsmall trauma, fewer complications, and postoperative recover quickly, clearfield, small effects of abdominal organs. To localized prostate cancer is safeand effective surgical treatment. Along with the increase of the averageoperation, performer to raise the level of operation, the operation time reducegradually, the effect of the operation was improved.