摘要
目的:探讨腹腔镜根治性前列腺切除术中采用尿道周围组织重建技术尿道膀胱吻合的安全性,早期尿控的有效性。方法:回顾性分析2012年3月至2013年1月37例采用"三明治"法尿道重建腹腔镜根治性前列腺切除术患者资料与同期34例未采用尿道重建患者临床资料,对比两组患者间年龄、体重指数、国际症状评分、前列腺体积、术前前列腺特异性抗原(prostate specific antigen,PSA)、术前Gleason评分,手术时间、失血量、术中输血率、术中性神经保留,术后留置尿管时间、住院时间、术后并发症及术后病理切缘阳性率,随访术后拔除尿管后1周、2周、4周、12周及24周患者尿控情况。结果:两组间患者年龄、体重指数、PSA、前列腺体积、IPSS(international prostate symptoms score)评分差异无统计学意义;术中出血量、术中输血率、术中性神经保留差异均无统计学意义,重建组手术时间比对照组长(P=0.003);术后留置尿管时间、住院时间、术后并发症及术后病理切缘阳性率差异也无统计学意义;重建组术后拔除尿管后4周、12周尿控率明显高于对照组(P=0.007,P=0.020)。结论:腹腔镜根治性前列腺切除术采用尿道周围组织重建膀胱尿道吻合技术,具有安全性和可行性,可以明显改善术后早期尿控。
Objective： To explore the safety and efficacy of ＂sandwich ＂urethra reconstruction in laparoscopic radical prostatectomy（ LRP） for the early recovery of continence. Methods： LRP was performed using a urethra surrounding tissue reconstruction in 37 consecutive patients,and without reconstruction procedure in 34 consecutive patients at the same period from March 2012 to January 2013. The baseline data,preoperative data： The patient age,body mass index（ BMI,kg / m2）,International prostate symptoms score（ IPSS）,prostate volume,preoperative PSA,Gleason score were assessed retrospectively;Operative data： The neurovascular bundle preservation,operation time,blood loss were assessed; and the primary outcome measure was urinary continence assessed at the end of 1,2,4,12 and 24 weeks after the catheter was removed. Other data recorded were duration of indwelling catheter,positive margin rate and complications. Results： There were no significant differences between the two groups with respect to baseline,preoperative and operative data except of the operative time（ P = 0. 003）. Between the two groups,the continence of the reconstruction group was higher than that of the control group at the end of4 and 12 weeks（ P = 0. 007,P = 0. 020,respectively）. Conclusion： Urethra surrounding tissue reconstruction in LRP is safe and feasible,and it could improve early recovery of continence.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2015年第4期601-604,共4页
Journal of Peking University:Health Sciences
基金
首都医科大学附属北京朝阳医院高层次卫生技术人才培养计划项目(2009-2-01)资助~~
关键词
腹腔镜
前列腺切除术
修复外科手术
尿失禁
Laparoscopy
Prostatectomy
Reconstructive surgical procedures
Urinary incontinence
