保留膀胱颈联合尿道前壁重建对腹腔镜下根治性前列腺切除术后早期尿控的影响

Effects of bladder neck preservation and anterior urethral wall reconstruction on early urinary control after laparoscopic radical prostatectomy

目的 探讨保留膀胱颈联合尿道前壁重建对腹腔镜根治性前列腺切除术后早期尿控的影响.方法 回顾性分析2015年4月至2017年6月,安徽省立医院泌尿外科26例行保留膀胱颈联合尿道前壁重建的腹腔镜根治性前列腺切除术（A组）和25例标准腹腔镜根治性前列腺切除术（B组）的患者临床资料,观察两组的手术所用时间、术中出血量、术后切缘阳性率、术后尿控情况以及两组围手术期并发症情况.结果 两组术中出血量、术后切缘阳性率以及围手术期并发症无统计学差异,手术时间差异有统计学意义（P＜0.05）,拔除导尿管后1周、4周、12周两组尿控率差异有统计学意义（P＜0.05）.结论 保留膀胱颈联合尿道前壁重建的腹腔镜根治性前列腺切除术是一种安全、可行的手术方法,对于改善术后早期尿控发挥了比较积极的作用.

Objective To investigate the effects of bladder neck preservation and anterior urethral wall reconstruction on early urinary control after laparoscopic radical prostatectomy.Methods From April 2015 to June 2017,retrospective analysis of 26 cases of urinary surgery in Anhui provincial hospital laparoscopic radical prostatectomy （group A） and 25 cases of standard laparoscopic radical prostatectomy prostatectomy （group B） patients with clinical data was performed.Operation time,blood loss,positive margins after surgery,urinary control recovery,perioperative complications were observed between the two groups.Results There wasno significant difference in bleeding volume,positive rate of incision margin and perioperative complications between the two groups.The difference in operativetime was statistically significant.There was a significant difference in urinary control rate between two groups after 1 week,4 weeks and 12 weeks after removalof urethral catheter （P ＜ 0.05）.Conclusions Laparoscopic radical prostatectomy with bladder neck combined with anterior urethral reconstruction is a safe and feasible surgical method.It plays a positive rolein improving early postoperative urinary control.