气膀胱腹腔镜前列腺剜除术的实验研究

An experimental study on laparoscopic pneumovesical enucleation of the prostate

目的通过对家犬进行气膀胱腹腔镜前列腺剜除术的实验研究，探讨如何利用腹腔镜技术经膀胱剜除前列腺的手术技巧。方法取8只4～6岁雄性家犬，气管麻醉下建立气膀胱，置入3个5mm穿刺鞘，利用腹腔镜器械在膀胱内分离前列腺，直视下将前列腺完整剜除。扩大切口，取出前列腺组织，分别留置膀胱造瘘管和尿管。结果本组8例，1例因出血过多失败，其余7例手术成功，手术时间85～190min，平均（125±42．31min，术中出血20～180ml，平均（45±30．8）ml。手术切除家犬前列腺组织12～36ml，平均（18．8±7．2）ml。7例家犬手术后排尿通畅，无尿失禁发生。结论气膀胱腹腔镜前列腺剜除术的实验研究证实该手术设计是合理的，实际操作是可行的，手术创伤小、出血少、效果好，实验研究的成功经验可为临床所借鉴和应用。

Objective To explore the application of laparoscopic pneumovesical enucleation of the prostate by using this procedure on dogs. Methods Pneumovesicum was established in 8 male dogs ages 4 to 6 under anesthesia. Three trocas 5mm in diameter were put into the bladders the prostates were dissected and enucleated laparoscopically. The incision sites were enlarged and the prostates were removed; and a bladder fistula tube and a catheter were placed. Results The procedure was successfully performed on 7 of 8 dogs but failed in one dog due to excessive bleeding. The surgical duration was 85 to 190 min [（125 ＋ 42.3）rain in average], intraoperative blood loss was 20 to 180 ml [（45 ± 30.8）ml in average], and the removed tissue was 12 to 36ml [（18.8 ± 7.2）ml in average]. All 7 dogs urinated smoothly after surgery and no incontinence occurred. Conclusions Our study shows laparoscopic enucleation of the prostate under pneumovesicum is reasonable, feasible, efficacious, and less invasive, and causes less bleeding. This successful experiment can be applicable to our clinical needs.