腹腔镜前列腺癌根治术中膀胱尿道吻合技术的改进及展望

Technology improvements and prospects of vesicourethral anastomosis in laparoscopic radical prostatectomy

前列腺癌根治术是治疗早期局限型前列腺癌的首选方法。随着腔镜器械的不断发展及手术技术的持续改进,腹腔镜前列腺癌根治术已成为治疗局限型前列腺癌的标准术式,它除了具有与开放手术一样的治疗效果外,还具有创伤小、恢复快的微创优势,迅速在国内大中型医院广泛开展。膀胱尿道吻合是腹腔镜前列腺癌根治术中最关键的步骤之一,如何减少膀胱尿道吻合的难度,提高手术效率并保证吻合的质量,是国内外泌尿外科专家所一直关注并期待解决的课题。本文总结了近几年国内外腹腔镜前列腺癌根治术中膀胱尿道吻合的技术改进和我们自身手术经验,与广大泌尿外科同行共飨。

Radical prostatectomy has become the preferred method in the treatment of organ-confined prostate cancer. With the development of endoscopic instrument and continuous modification of surgical technology, laparoscopic radical prostatectomy has become a standard surgical treatment for localized prostate cancer. Compared with open approach, laparoscopic radical prostatectomy can achieve the same therapeutic effects with less trauma and faster recovery. Therefore, it has been widely performed in domestic large to medium-sized hospital. Endo- scopic reconstruction of the vesicourethral anastomosis is one of the most critical steps in the procedure. How to reduce the difficulty of the vesicourethral anastomosis, increase surgical efficiency and ensure consistent quality has been a concern by urology experts. In this paper, we will summarize some technical improvements in recent years and review our own surgery skills in the vesicourethral anastomosis. We hope to share our knowledge to all urolo- gists.