前列腺癌根治术中背侧血管复合体免缝扎的技巧和效果总结

Technique and effect of DVC free suture in radica prostatectomy

目的探讨腹腔镜前列腺癌根治术(LRP)中免缝扎背侧血管复合体(DVC)的技巧和临床疗效。方法回顾性分析扬州大学附属医院2015年1月至2018年6月由同一术者主刀完成的45例LRP患者资料。其中24例术中缝扎DVC(DVC缝扎组),21例术中未缝扎DVC(DVC免缝扎组)。结果所有患者均顺利完成手术。两组患者手术时间、术中出血量、手术切缘阳性率、输血率相比,差异无统计学意义(P>0.05)。两组术后1周、1个月、3个月的排尿可控率、勃起功能恢复率相比,差异无统计学意义(P>0.05);术后6个月,DVC免缝扎组的排尿可控率(75.19%)高于DVC缝扎组(45.83%),DVC免缝扎组的勃起功能恢复率(71.43%)高于DVC缝扎组(41.67%),差异均有统计学意义(P<0.05)。结论改良后的DVC免缝扎技术在LRP中的应用是安全有效的,更有利于术后控尿功能及性功能的早期恢复。

Objective To explore the technique and clinical efficacy of suture-free dorsal vascular complex (DVC) in laparoscopic radical prostatectomy (LRP). Methods A retrospective analysis of 45 patients with LRP who were treated by the same surgeon from January 2015 to June 2018 in our hospital was performed.Among them, 24 cases underwent DVC suture (the DVC suture group) and 21 cases underwent DVC suture without DVC suture (the DVC suture free group). Results All patients completed the operation smoothly.There was no significant difference in operation time, blood loss, positive rate of incision margin and transfusion rate between the two groups ( P >0.05).There was no significant difference in urination control rate and erectile function recovery rate between the two groups at the 1th week, the 1th month and 3rd month after operation ( P >0.05).At 6 months after operation, the urination control rate of the DVC suture-free group (75.19%) was higher than that of the DVC suture group (45.83%).The erectile function recovery rate of the DVC suture-free group (71.43%) was higher than that of the DVC suture group (41.67%)significantly( P< 0.05). Conclusions The modified DVC suture-free technique is safe and effective in LRP, and is more conducive to the early recovery of postoperative continenece and sexual function.