保留尿道远端括约肌控尿复合体在腹腔镜前列腺癌根治术中的初步应用研究

Primary application of the preservation of distal urethral sphincter complex in laparoscopic radical prostatectomy

目的:探讨保留尿道远端括约肌控尿复合体的新技术应用于腹腔镜前列腺癌根治术中的价值。方法:以2018年4月至2018年8月收治的20例中低危前列腺癌患者为研究对象,采用保留尿道远端括约肌控尿复合体技术的腹腔镜前列腺癌根治术。收集患者术前基线数据、围手术期护理数据、手术时间、术中出血量、术后住院时间、术后并发症、导尿管留置时间、术后完全尿控时间、切缘阳性率等数据。结果:20例手术均顺利完成。手术时间平均(108.5±18.2)min,术中出血量中位数96(58.0~164.2)mL,术后平均住院(4±0)d,导尿管留置时间平均(14±0)d。切缘阳性率10%。术后2周拔除导尿管后即刻完全控尿率75%,术后6个月完全控尿率95%。结论:腹腔镜前列腺癌根治术中采用保留尿道远端括约肌控尿复合体新技术安全、可行,术后短期尿控率高,但操作难度较大,术者需充分熟悉前列腺解剖并具有熟练的腹腔镜技术。

Objective:To investigate the application of a new technique for the preservation of distal urethral sphincter(DUS)complex in laparoscopic radical prostatectomy(LRP).Methods:Twenty patients with intermediate-and low-risk prostate cancer were enrolled in the study from Apr.2018 to Aug.2018.All the patients underwent LRP with DUS complex preservation technique.The preoperative baseline data,operative time,intraoperative bleeding volume,postoperative hospital stay,postoperative complications,catheter indwelling time,time of continence,positive surgical margin rate were collected retrospectively Results:All the 20 operations were successfully completed with a mean operative time of(108.5±18.2)min.The median intraoperative bleeding volume was 96(58.0~164.2)mL.The mean postoperative hospital stay was(4±0)d.The catheter in dwelling time was(14±0)d.The positive surgical margin rate was 10%.Immediate continence rate was 75%.The rate of continence at 6 months was 95%.Conclusions:The new technique of DUS complex preservation in LRP is safe and feasible.The short-term continence rate is better than before,but the technique is relatively complex.It requires the surgeon to be familiar with prostate anatomy and laparoscopic skills.