根治性前列腺切除术围手术期整合康复中国专家共识（2024年版）

中国抗癌协会泌尿生殖肿瘤整合康复专业委员会

doi:10.19401/j.cnki.1007-3639.2024.09.009

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根治性前列腺切除术围手术期整合康复中国专家共识（2024年版）

指南与共识 | 更新时间：2025-12-31

- 根治性前列腺切除术围手术期整合康复中国专家共识（2024年版）
- Chinese expert consensus on perioperative integrated rehabilitation for radical prostatectomy (2024 edition)
- 中国癌症杂志 2024年34卷第9期页码：890-902
- 作者机构：
- 作者简介：
- 基金信息：
  
  国家重点研发计划(2022YFC3602900);中央高水平医院临床科研业务费-BJ-2022-115
- DOI：10.19401/j.cnki.1007-3639.2024.09.009
  中图分类号： R737.25
- 收稿：2024-07-02，
  
  修回：2024-09-09，
  
  纸质出版：2024-09-30
- 稿件说明：
移动端阅览
中国抗癌协会泌尿生殖肿瘤整合康复专业委员会. 根治性前列腺切除术围手术期整合康复中国专家共识（2024年版）[J]. 中国癌症杂志, 2024,34(9):890-902.

of Integrated Rehabilitation for Urogenital Tumors Committee, Anti-Cancer Association Chinese. Chinese expert consensus on perioperative integrated rehabilitation for radical prostatectomy (2024 edition)[J]. China Oncology, 2024, 34(9): 890-902.
中国抗癌协会泌尿生殖肿瘤整合康复专业委员会. 根治性前列腺切除术围手术期整合康复中国专家共识（2024年版）[J]. 中国癌症杂志, 2024,34(9):890-902. DOI： 10.19401/j.cnki.1007-3639.2024.09.009.

of Integrated Rehabilitation for Urogenital Tumors Committee, Anti-Cancer Association Chinese. Chinese expert consensus on perioperative integrated rehabilitation for radical prostatectomy (2024 edition)[J]. China Oncology, 2024, 34(9): 890-902. DOI： 10.19401/j.cnki.1007-3639.2024.09.009.

摘要

前列腺癌是男性常见的恶性肿瘤之一，根治性前列腺切除术（radical prostatectomy，RP）是局限性及局部晚期前列腺癌的主要治疗手段。由于手术创伤影响，RP后患者将面临性功能障碍、尿失禁等并发症，这些问题都将导致患者的生活质量不同程度的下降，而目前临床上对患者的康复指导尚未达成统一意见。因此，中国抗癌协会泌尿生殖肿瘤整合康复专业委员会召集相关专家采用循证医学的方法，通过查阅和评估相关文献，进行质量等级评价、证据综合及编写初稿后，采用专家会议讨论、德尔菲问卷调查等方法，经过3轮对24个不同医院共计29名专家的意见进行调查，并将结果进行梳理总结，形成《根治性前列腺切除术围手术期整合康复中国专家共识（2024年版）》。以期为接受RP的患者提供标准化的整合康复意见，提高术后恢复效率，减少RP引起的短期或长期并发症对患者的生活质量所造成的影响。本共识已在国际实践指南注册与透明化平台（Practice guideline REgistration for transPAREncy，PREPARE）上注册，注册编号为PREPARE-2024CN666。本共识内容包括围手术期的全面评估、加速康复外科（Enhanced Recovery After Surgery，ERAS）理念的应用、术后常见并发症的管理与治疗及患者的心理与社会支持等多个方面。在围手术期评估方面，共识强调了术前对患者的身体和心理状况进行全面评估，包括营养状态、盆底功能和心理状态等，旨在制订个性化的康复计划，优化术前准备，为术后恢复打下基础。ERAS理念则通过减少术前禁食及禁饮时间、改进围手术期管理、开展术前教育和心理干预等措施，有效地减少术后并发症的发生率，加速患者的术后恢复。针对术后尿失禁和性功能障碍等常见并发症，共识推荐了包括盆底肌训练（pelvic floor muscle training，PFMT）、生物反馈治疗等多种康复措施，以减轻患者的症状并改善其生活质量。此外，本共识还强调了术后患者的心理和社会支持，建议在术后给予患者充分的心理和社会支持。本共识的发布将为临床医师提供标准化的术后康复指导，有助于提高接受RP患者的术后康复效率，减少并发症的发生，从而显著改善患者的生活质量。未来，随着更多临床研究的开展，本共识内容将不断得到验证和优化，从而为前列腺癌患者带来更全面和个性化的康复指导。

Abstract

Prostate cancer is one of the most common malignancies in men

and radical prostatectomy (RP) is the primary treatment method for localized and locally advanced prostate cancer. However

due to surgical trauma

patients undergoing RP often face postoperative complications such as sexual dysfunction and urinary incontinence

leading to varying degrees of decline in quality of life. Currently

there is a lack of standardized clinical guidelines for postoperative rehabilitation in these patients. To address this issue

the present consensus was developed using evidence-based medicine approaches

including a thorough review and evaluation of relevant literature

quality grading

and evidence synthesis. An initial draft was created and subsequently refined through expert meetings

discussions and Delphi surveys. This process involved three rounds of consultations with 29 experts from 24 different hospitals across various specialties

including urology

oncology

rehabilitation medicine

nutrition and psychology. The results were systematically summarized under the guidance of the Committee of Integrated Rehabilitation for Urogenital Tumors

Chinese Anti-Cancer Association

culminating in the formulation of the “Chinese expert consensus on perioperative integrated rehabilitation for radical prostatectomy (2024 edition)”. This consensus aimed to provide standardized integrated rehabilitation recommendations for patients undergoing RP

with the goals of improving postoperative recovery efficiency and reducing the impact of both short- and long-term complications on survival and quality of life. The consensus has been registered on Practice guideline REgistration for transPAREncy (PREPARE) with the registration number PREPARE-2024CN666. The consensus covers several key areas

including comprehensive perioperative assessment

application of the Enhanced Recovery After Surgery (ERAS) principles

management and treatment of common postoperative complications

and psychological and social support for patients. Regarding perioperative assessment

the consensus emphasizes a thorough evaluation of patients’ physical and psychological conditions before surgery

including nutritional status

pelvic floor function and psychological state

to develop individualized rehabilitation plans and optimize preoperative preparation

thereby laying a solid foundation for postoperative recovery. The application of ERAS principles includes reducing preoperative fasting and fluid restrictions

improving perioperative management

providing preoperative education

and implementing psychological interventions

all of which effectively reduce the incidence of postoperative complications and accelerate recovery. For common postoperative complications such as urinary incontinence and sexual dysfunction

the consensus recommends various rehabilitation measures

including pelvic floor muscle training (PFMT) and biofeedback therapy

to alleviate symptoms and improve quality of life. Additionally

the consensus underscores the importance of psychological and social support

advising comprehensive support for patients in the postoperative period. The publication of this consensus provides clinical practitioners with standardized guidelines for postoperative rehabilitation

which can enhance the recovery efficiency of patients undergoing RP

reduce the incidence of complications

and significantly improve the quality of life. As more clinical studies are conducted in the future

the content of this consensus will be continuously validated and refined

offering more comprehensive and personalized rehabilitation guidance for prostate cancer patients.

关键词

Keywords

references

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