使用会阴牵引法吻合膀胱尿道在腹腔镜前列腺癌根治术中的初步探索

Ureterovesical anastomosis aided by perineal traction in laparoscopic radical prostatectomy:A preliminary study

目的探讨腹腔镜前列腺癌根治术中使用会阴牵引法吻合膀胱尿道代替传统常规的吻合法的临床应用。方法回顾分析本院2019年11月至2020年11月收治的局限性前列腺癌患者18例,均行腹腔镜前列腺癌根治手术,其中8例(n=8)患者行会阴牵引法,10例(n=10)患者行常规膀胱尿道吻合术。所有患者均进行为期1~12个月的随访,对患者治疗效果进行评估,比较两组手术指标、术后并发症及术后疼痛评分的差异。结果观察组总手术时间平均为(184.88±23.64)min,膀胱尿道吻合时间平均为(19.63±4.81)min,明显低于对照组(均P<0.05)。观察组术后并发症吻合口漏、吻合口狭窄、尿失禁、切缘阳性、术后复发发生率与对照组差异无统计学意义(均P>0.05)。结论在腹腔镜前列腺癌根治术膀胱尿道吻合过程中,使用会阴牵引法,能够利于简化手术过程、降低手术难度、缩短手术时间、有效控尿。

Objective To investigate the clinical value of perineal traction for ureterovesical anastomosis in laparoscopic radical prostatectomy as a substitute of the conventional anastomosis option.Methods A retrospective study was conducted on 18 patients with localized prostate cancer admitted to our hospital between November 2019 and November 2020.All subjects underwent laparoscopic radical surgery for prostate cancer;of whom,ureterovesical anastomosis was aided by perineal traction(n=8)or via conventional option(n=10).The patients were followed up for 1-12 months to evaluate the treatment efficacy and compare the differences in surgical indicators,postoperative complications and scores of postoperative pain between groups.Results In the study group,the meantime for the whole procedure was(184.88±23.64)min,and that for ureterovesical anastomosis was(19.63±4.81)min,which were significantly shorter than those in the control group(all P<0.05).Postoperative complications such as leakage and stenosis of anastomosis,and urinary incontinence,positive resection margins,and postoperative recurrence did not differ statistically between the study group and the control group(all P>0.05).Conclusion During laparoscopic radical prostatectomy,ureterovesical anastomosis aided by perineal traction can result in simplified procedure,less surgical challenge,shorter operation time,and effective urine control.