机器人辅助腹腔镜前列腺癌根治术的三种缝线比较

Comparison of the efficiency of three kinds of suture line for urethrovesical anastomosis during robotic assisted laparoscopic prostatectomy

目的 分析Da Vinci机器人辅助腹腔镜前列腺癌根治术（RARP）患者的临床资料,评价三种缝线的疗效与安全性.方法 回顾性分析106例RARP患者的相关资料,按照缝线种类分为Quill组32例、V-Loc组40例、Y604组34例,对三组患者的基线资料、围手术期资料及首次随访资料进行统计分析.结果 三组患者的基线资料可比（P＞0.05）;围手术期的线体松弛、滑脱（x2 =18.958,P=0.001）、尿道-膀胱吻合时间（P=0.047）及术后平均住院时间（P =0.026）差异有统计学意义;术后1周内主要并发症的总发生率为9.43％ （10/106）,组间差异无统计学意义（P＞0.05）;三组患者首次随访资料组间无统计学差异（P＞0.05）.结论 综上所述,相对于Quill和Y604,V-Loc缝线或可缩短尿道-膀胱吻合时间,降低线体松弛、滑脱发生率,减少患者术后住院日.在安全性方面,三种缝线术后1周内主要并发症及初次随访资料均无统计学差异,但是否具有远期优势或者不良反应仍需长期多中心随机对照试验进行证实.

Objectives To investigate the efficacy and safety of three kinds of suture line for urethrovesical anastomosis during robotic assisted laparoscopic prostatectomy（RALP）.Methods Data were collected from 106 consecutive patients undergoing RALP for prostate cancer.According to the sutures used in urethrovesical anastomosis,106 patients were divided into three groups,Quill Group （QullTM,Cananda） （32 cases）,V-Loc （Covidien,MA,USA） group （40 cases）,Y604（Ethicon,USA） group（34 cases）.Baseline data,perioperative and first follow-up data of three groups were statistically analyzed.Results The differences of baseline data of the three groups were not statistically significant （P 〉 0.05）.The differences of line relaxation（x2 =18.958,P =0.001）,the time of urethrovesical anastomosis （P =0.047） and the mean postoperative hospital stay（P =0.026） were statistically significant.The overall incidence of major complications was 9.43% within one week postoperatively.The differences of first follow-up data in three groups were not statistically significant （P〉 0.05）.Conclusions In summary,V-Loc suture could shorten the urethrovesical anastomosis time,reduce the incidence of line body relaxation and postoperative hospital stay compare with Quill and Y604 sutures.In terms of safety,the major complications and follow-up data were not statistically different in one week after operation.However,the advantage of long-term or long-term adverse effects still need to be proved by multiple-center,large-sample randomized controlled trials.