超声刀直接烧灼法处理DVC在腹腔镜膀胱癌根治性切除术中的应用

Application of direct cauterization with ultrasonic scalpel to DVC in laparoscopic radical resection of bladder cancer

目的:探讨应用超声刀直接烧灼法处理阴茎背深静脉复合体(dorsal venous complex,DVC)在腹腔镜膀胱癌根治性切除术中的可行性与有效性。方法:回顾性分析2012年7月至2016年12月收治的32例男性患者的临床资料,超声刀直接烧灼法处理组17例,结扎法处理组15例,对比患者两种手术方式的手术时间、术中出血量、术后拔除尿管天数、术后控尿率。结果:超声刀直接烧灼法处理组与结扎法处理组手术时间分别为(360.36±5.95)min、(482.36±8.95)min;两种手术方式手术时间比较差异有统计学意义(P<0.05)。术中出血量分别为(250.36±7.14)m L、(248.14±8.45)m L;术后拔除尿管天数分别为(13.22±0.86)d、(13.44±0.71)d;两种手术方式的拨尿管天数及术中出血量比较差异无统计学意义(P>0.05),术后3个月控尿率分别为100.00%、86.67%,两种手术方式的控尿率比较差异有统计学意义(P>0.05)。结论:超声刀直接烧灼法处理DVC,手术时间短,术中出血量不增加,术后恢复快,控尿率高。

Objective:To investigate the feasibility and effectiveness of direct cauterization with ultrasonic scalpel in the treatment of dorsal venous complex(DVC)in laparoscopic resection of bladder cancer.Methods:The clinical data of 32 patients hospitalized from July 2012 to December 2016 were retrospectively analyzed.17 patients were treated with direct cauterization with ultrasonic scalpel while 15 patients were treated with ligation,with the operation time,the intraoperative blood loss,the number of days after catheter removal,and the postoperative urinary control rate compared between the two surgical methods.Results:The operation time of direct cauterization and ligation was(360.36±5.95)min and(482.36±8.95)min respectively;the intraoperative blood loss was(250.36±7.14)ml and(248.14±8.45)ml respectively;the number of days of urinary catheter removal was(13.22±0.86)d and(13.44±0.71)d respectively;the urinary control rate was 100.00%and 86.67%respectively 3 months after the operation.Conclusion:Direct cauterization with Ultrasound scalpel in the treatment of DVC has the characteristic of shorter operation time,less intraoperative bleeding,quicker postoperative recovery and higher urinary control rates.