摘要
目的 探讨可调式“回形针”法缝合背深静脉复合体(DVC)及功能尿道保留技巧在机器人辅助腹腔镜前列腺癌根治术(RALRP)中的应用。方法 纳入30例采用可调式“回形针”法缝扎DVC的RALRP患者。术中用倒刺线贯穿缝合DVC,通过两条前列腺韧带反向缝合。打结后,用Hem-Lock夹子固定缝线,术中可灵活控制松紧程度。回顾并随访分析患者围手术期资料及尿控恢复情况。结果 30例均顺利完成RALRP,可调式“回形针”法控制术中出血量为(123.3±80.7) mL。53.6%的患者在术后1个月可恢复自主尿控,在术后3、6个月时自主控尿率分别提高到92.9%和96.3%。分析显示92.9%的患者术后3个月无尿失禁风险。结论 可调式“回形针”法缝合有助于帮助减少DVC相关出血,保持手术视野清晰度,从而确保功能尿道保留,改善术后自主尿控恢复。
Objective To investigate the efficacy of the adjustable“paper clip”techniques in the suture of dorsal vein complex(DVC)and retention of urethral function in robot-assisted laparoscopic radical prostatectomy(RALRP).Methods A total of 30 cases of prostate cancer treated with RALRP were enrolled,all of which used the adjustable“paper clip”techniques.During operation,the DVC was sewed with barbed suture,and then a reverse suture was made through two sides of the prostatic ligaments.A Hem-o-lock was used to fasten the suture,which would be flexible to control the degree of tightness for the ligature.Perioperative and follow-up data of urinary continence and symptoms were collected and analyzed.Results All operations were successful.The estimated blood loss was(123.3±80.7)mL,53.6%patients recovered continence in 1 month,and the continence rate increased to 92.9%and 96.3%at month 3 and 6.92.9 of patients had no risk of incontinence 3 months after surgery.Conclusion The adjustable“paper clip”techniques have advantages in reducing blood loss,maintaining clear surgical field,preserving urethral function,and improving urinary continence.
作者
陈阳
张方兴
李天宇
黎承杨
刘德云
颜海标
杨占斌
米华
莫林键
廖乃凯
杨舒博
程继文
CHEN Yang;ZHANG Fangxing;LI Tianyu;LI Chengyang;LIU Deyun;YAN Haibiao;YANG Zhanbin;MI Hua;MO Linjian;LIAO Naikai;YANG Shubo;CHENG Jiwen(Department of Urology,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)
出处
《现代泌尿外科杂志》
CAS
2023年第8期707-712,共6页
Journal of Modern Urology
基金
国家自然科学基金项目(No.82160483)
广西泌尿系统疾病临床医学研究中心项目(No.桂科AD20297081)
广西科技基地和人才专项(No.桂科AD20238090)。
关键词
机器人辅助腹腔镜前列腺癌根治术
可调式“回形针”法
背深静脉复合体
尿控
功能尿道
robot-assisted laparoscopic radical prostatectomy
adjustable“paper clip”techniques
dorsal vein complex
urinary continence
functional urethra
