目的：探讨机器人辅助手术应用于前列腺癌患者的临床效果。方法：回顾性分析 2019 年 1 月—2021 年 12 月青岛市市立医院收治的 96 例前列腺癌患者临床资料，通过随机数表法分为腹腔镜组（48 例）和机器人组（48 例）。腹腔镜组予以常规腹腔镜前列腺癌根治术治疗，机器人组通过机器人辅助腹腔镜前列腺癌根治术治疗，对比 两组患者围手术期指标、住院费用、国际前列腺症状评分、国际勃起功能指数问卷表 -5 评分及术后并发症发生情况。 结果：机器人组手术时间、住院时间、术中出血量及围手术期输血率较腹腔镜组少，但住院费用较腹腔镜组高，差 异具有统计学意义；两组随访 6 个月后 IPSS 评分均低于术前，且机器人组评分低于腹腔镜组，差异具有统计学意义； 两组随访 6 个月后 IIEF-5 评分较术前均提高，且腹腔镜组随访 6 个月后 IIEF-5 评分明显低于机器人组同时间点评分， 差异具有统计学意义；机器人组术后并发症发生率较腹腔镜组低，差异具有统计学意义。结论：与 LRP 手术相比， RALP 手术更有助于改善前列腺癌患者围手术期指标，其在改善患者前列腺症状及性功能水平方面更具优势，有利 于减少术后并发症。

Objective: To explore the clinical effect of robot-assisted surgery on prostate cancer. Methods: The clinical data of 96 patients with prostate cancer admitted to Qingdao Municipal Hospital from January 2019 to December 2021 were retrospectively analyzed. All patients were divided into the laparoscopic group (48 cases) and robotic group (48 cases) with random number table. The laparoscopic group was treated with laparoscopic radical prostatectomy, and the robotic group was treated with robot-assisted laparoscopic radical prostatectomy. The perioperative indexes, hospitalization costs, international prostate symptom score, international index of erectile function-5 and postoperative complications of the two groups were compared and analyzed. Results: The operative time, hospital stay, intraoperative blood loss and perioperative blood transfusion rate of the robotic group were less than those of the laparoscopic group, but the hospitalization cost was higher than that of the laparoscopic group, the difference was statistically significant. After 6 months of follow-up, IPSS scores of the two groups were lower than those before surgery, with the IPSS score of the robotic group lowering than that of the laparoscopic group, and the differences were statistically significant; Compared with the preoperative IIEF-5 score, the scores of the two groups both increased after 6 months of follow-up, the score of IIEF-5 in the laparoscopic group after 6 months of follow-up was significantly lower than that in the robotic group, and the difference was statistically significant; The incidence of postoperative complications in the robotic group was lower than that in the laparoscopic group, and the difference was statistically significant. Conclusion: Compared with LRP , RALP could improve the perioperative indexes of patients with prostate cancer, and it has more advantages in improving prostate symptoms and sexual function, which is conducive to reducing postoperative complications.

收稿日期：2022-07-29  录用日期：2022-08-16 

Received Date: 2022-07-29  Accepted Date: 2022-08-16 

通讯作者：张学平，Email：2838804027@qq.com 

Corresponding Author: ZHANG Xueping, Email: 2838804027@qq.com 

引用格式：李名城，张学平，章语 . 机器人辅助手术在前列腺癌患者中的应用效果及术后并发症分析 [J]. 机器人外科学杂志（中英 文），2023，4（3）：227-232. 

Citation: LI M C, ZHANG X P, ZHANG Y. Clinical efficacy and postoperative complications of robot-assisted surgery in patients with prostate cancer[J]. Chinese Journal of Robotic Surgery, 2023, 4(3): 227-232.

[1] 沈敏强 , 李鹏 , 杨荣华 . 腹腔镜下前列腺癌手术直 肠损伤的诊治探讨 ( 附 7 例报告 )[J]. 中华男科学杂 志 , 2022, 28(5): 427-431.

[2] 薛梅平 , 王春樱 , 胡文婷 , 等 . 机器人辅助手术改 善腹腔镜下前列腺癌根治术患者术后尿控功能恢 复程度的临床疗效观察 [J]. 中华男科学杂志 , 2022, 28(6): 501-505. 

[3] 黄俊 , 卢剑 , 方建雄 . 老年局限性前列腺癌患者腹 腔镜手术后发生尿失禁的影响因素 [J]. 中国老年学 杂志 , 2022, 42(9): 2113-2116. 

[4] 王方明 , 韩苏军 , 杨飞亚 , 等 . 高危前列腺癌腹腔 镜根治性前列腺切除术后切缘阳性的危险因素 [J]. 中华泌尿外科杂志 , 2021, 42(5): 349-354. 

[5] 张琦 , 祁小龙 , 刘锋 , 等 . 机器人辅助经膀胱颈纵 切口根治性前列腺切除术治疗早期前列腺癌的疗 效分析 [J]. 中华泌尿外科杂志 , 2021, 42(11): 819- 823. 

[6] 金杰 . 前列腺外科学 [M]. 8 版 . 北京 : 人民卫生出 版社 , 2013: 245． 

[7] Choi W S, Son H. The change of IPSS 7 (nocturia) score has the maximum influence on the change of Qol score in patients with lower urinary tract symptoms[J]. World J Urol, 2019, 37(4): 719-725. 

[8] van Kollenburg R A A, de Bruin D M, Wijkstra H. Validation of the electronic version of the international index of erectile function (IIEF-5 and IIEF-15): a crossover study[J]. J Med Internet Res, 2019, 21(7): e13490. 

[9] Cullen P K Jr, Welch J S. Ten year results of the kelly and kennedy types of procedure in urinary stress incontinence[J]. Surg Gynecol Obstet, 1961 , 11(3): 85- 90. 

[10] 任尚青 , 卫义 , 王尧谦 , 等 . 腹膜外有无专用通道 装置单切口机器人辅助腹腔镜根治性前列腺切除 术的疗效比较 [J]. 中华医学杂志 , 2021, 101(40): 3345-3350. 

[11] 何双双 . 达芬奇机器人辅助前列腺癌手术应用评价 [J]. 解放军医院管理杂志 , 2021, 28(6): 558-560. 

[12] 朱敏 , 宋辉 , 张成 . 达芬奇机器人辅助腹腔镜行前 列腺癌根治术的探讨 [J]. 江西医药 , 2019, 54(12): 1483-1484, 1496. 

[13] 徐林锋 , 邱雪峰 , 张青 , 等 . 改良后入路机器人辅助 根治性前列腺切除术治疗移行带前列腺癌的安全 性和疗效 [J]. 中华泌尿外科杂志 , 2022, 43(2): 107- 110. 

[14] 东洁 , 陈勇吉 , 徐维锋 , 等 . 经膀胱前入路和经膀 胱后入路机器人辅助前列腺癌根治术早期效果比 较 [J]. 中华外科杂志 , 2021, 59(11): 902-906. 

[15] 强济斌 , 黄晓菲 , 吴志强 , 等 . 机器人辅助腹腔镜 与标准腹腔镜治疗局限性前列腺癌的疗效对比 [J]. 中国卫生标准管理 , 2022, 13(2): 39-43. 

[16] 熊柱凤 , 汤利萍 . 达芬奇机器人前列腺癌根治术患 者生存质量及影响因素 [J]. 中国老年学杂志 , 2019, 39(2): 437-440.