改良侧方精囊入路前列腺癌根治术在即刻尿控中的应用
Application of immediate urinary continence recovery in prostate cancer patients undergoing radical prostatectomy via modified lateral seminal vesicle approach
占习双 1刘全明 1吴天鹏 2欧阳骏3
作者信息
- 1. 浙江省中医药大学附属温岭市中医院泌尿外科 浙江 温岭 317500
- 2. 武汉大学人民医院泌尿外科 湖北 武汉 430060
- 3. 苏州大学附属第一医院泌尿外科 江苏 苏州 215006
- 折叠
摘要
目的:探讨腹腔镜下侧方精囊入路保留膀胱颈口技术在前列腺癌根治术中的早期尿控恢复的效果.方法:回顾性分析2021年9月至2022年12月温岭市中医院收治的T1～T3b期39例采用腹腔镜下侧方精囊入路解剖性保留膀胱颈技术的前列腺癌患者.记录保留膀胱颈完整性及成功率,膀胱尿道吻合时间,拔除导尿管时间,住院时间,拔除导尿管后1周、1月及3月时尿控评分及尿垫情况,不良事件情况等.结果:39例手术均顺利,完整保留膀胱颈成功率为100%,术中吻合膀胱尿道时间为10～15 min,平均(12.0±1.8)min.术后住院时间为9～11 d,术后1周尿控率27/39(69.2%),1月尿控率34/39(87.2%),3月尿控率38/39(97.4%),其中1例3.5月恢复尿控.结论:腹腔镜下侧方精囊入路技术在前列腺癌根治术中完整地保留了膀胱颈口,可以更好地恢复尿控功能,术后即刻尿控能力大大提高,患者术后生活质量明显提升,是一项值得推广的新技术.
Abstract
Objective:To study the effect of laparoscopic radical prostatectomy with bladder neck preserva-tion by lateral seminal vesicle approach in early urinary continence recovery.Methods:From Septem-ber 2021 to December 2022,a total of 39 patients with prostate cancer in the T1-T3b stage who un-derwent a laparoscopic lateral seminal vesicle approach for anatomical preservation of the bladder neck were retrospectively analyzed.The integrity and success rate of retaining the bladder neck,the time of vesico-urethral anastomosis,the time of catheter removal,hospital stay,urinary control score at the first week,first month,and third-month post-catheter removal,and the condition of urine pad and ad-verse events,etc.,were recorded.Results:All 39 cases were operated smoothly,the success rate of completely preserving the bladder neck was 100%,and the intraoperative anastomosis time of bladder and urethra was 10～15 min,with an average of(12.0±1.8)min.The postoperative hospital stay was 9～11 days,and the urinary continence rate was 27/39(69.2%)one week after the operation,34/39(87.2%)in one month,and 38/39(97.4%)in three months,among which one case recovered in 3.5 months.Conclusion:The modified laparoscopic lateral seminal vesicle approach completely pre-serves the bladder neck in radical prostatectomy,which can better restore the urinary control function,improve the ability of urinary control immediately after surgery,and significantly improve the post-surgery quality of life.It is a new technique worthy of promotion.
关键词
前列腺癌/腹腔镜前列腺癌根治术/即刻尿控/精囊入路Key words
Prostate Cancer/Laparoscopic Radical Prostatectomy/Immediate Urine Conti-nence/Seminal Vesicle Approach引用本文复制引用
基金项目
浙江省卫生厅资助项目(21ywb124)
浙江省温岭市科技局资助项目(2018C312019)
出版年
2024
NETL
NSTL
万方数据