Effect of extraperitoneal approach on tPSA, fPSA and immune index in patients with prostate cancer undergoing modified single hole laparoscopic surgery
ZHANG Mingyan
HAN Qipeng
GUAN Xiaochuan
QIU Huayong
Abstract：Objective To investigate the effect of extraperitoneal approach on tPSA,fPSA and immune index in patients with prostate cancer undergoing modified single hole laparoscopic surgery.Methods Ninety cases of patients with prostate cancer were selected,who were treated in hospital from January 2010 to January 2017,and they were divided into the observation group(45 cases)and control group(45 cases).The patients in observation group were treated with extraperitoneal approach modified single hole laparoscopic surgery,while the patients in control group were treated with intraperitoneal approach modified single hole laparoscopic surgery.After surgery,the patients of two groups were all treated with enhance-nutritional support,conventional anti-infective,added intravenous blood volume,and ensure smooth drainage of the catheter.The operation time,recovery time of gastrointestinal function,intraoperative blood loss,length of hospital stay were compared,followed up of 1 to 6 months,postoperative complications and changes of the levels of IgG,IgA,IgM,C3,C4,tPSA,fPSA,CD3+,CD4+,CD8+of two groups were compared.Results The operation time,recovery time of gastrointestinal function,intraoperative blood loss,length of hospital stay of the observation group were significantly lower than those of the control group(x2=1.742,x2=3.989,x2=5.190,x2=2.939,P=0.042,P=0.000,P=0.000,P=0.002);The levels of IgG,IgA,C3,C4,CD3+,CD4+,CD4/CD8 decreased in the first day after operation(P<0.01),the levels of IgG,IgA,C3,C4,CD3+,CD4+,CD4/CD8 were significantly increased in the 7th day after operation,CD8 levels significantly decreased(P<0.01),while IgM levels had no significant change(P>0.05);The magnitude of the rise of observation group was significantly higher than the control group(P<0.05),CD8 decreased significantly lower than the control group(P<0.01);The levels of tPSA and fPSA in the observation group were significantly lower than those in the control group on the 1st and 7th day after operation(P<0.01);There were pelvic hematoma,urethral stricture,stress urinary incontinence,urinary retention and unilateral inguinal hernia occurred in both two groups in the follow up of 1 to 6 months,and the incidence in the observation group were significantly lower than the control group(x2=4.282,x2=6.932,x2=4.499,x2=4.909,x2=6.379,P=0.039,P=0.008,P=0.034,P=0.027,P=0.011).Conclusion The modified single hole laparoscopic surgery for the treatment of prostate cancer is effective and minimally invasive,and it is beneficial to protect the immune function of patients with less complications and good safety.
Keywords：Prostate cancerExtraperitoneal approachModified single laparoscopeImmune function
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 817-820,829 )