机器人辅助前列腺癌根治术两种引流对比分析

CComparative analysis of suprapuboid bladder drainage and transurethral indwelling urethral catheter drainage during robotic assisted radical prostatectomy

目的:研究对比机器人辅助根治老年前列腺癌术后耻骨上引流与经尿道引流的效果。方法:纳入从2017年1月~2019年1月我院收治的老年前列腺癌患者90例进行研究,所选患者均行机器人辅助前列腺根治性切除术治疗。将其以信封法随机等分成耻骨组和尿道组。耻骨组术后实施耻骨上引流,尿道组术后实施经尿道引流。比较两组术后引流时间、住院时间对比以及胃肠功能恢复时间对比),手术后1~3d的术区疼痛改善情况,术后并发症发生情况,各项手术指标情况。结果:耻骨组术后引流时间、胃肠功能恢复时间均显著短于尿道组(均P<0.05)。耻骨组术后1d、2d、3d时的VAS评分均显著低于尿道组(均P<0.05)。耻骨组术后并发症总发生率显著低于尿道组(P<0.05)。耻骨组术后3个月及时控尿率高于尿道组(P<0.05)。结论:机器人辅助根治老年前列腺癌术后耻骨上引流相较于经尿道引流的效果更优,可显著减轻患者术后疼痛,降低术后并发症发生风险,安全性较好,值得临床推广应用。

Objective:To study and compare the effects of suprapubic drainage and transurethral drainage assisted by robot after radical treatment of senile prostate cancerand compare the efficacy of suprapubic drainage and transurethral drainage after radical resection of senile prostate cancer.Methods:A total of 90 elderly patients with prostate cancer admitted to our hospital from January 2017 to January 2019 were included in the study.All patients underwent robot-assisted radical prostatectomy.They were randomly divided into pubic group and urethra group by envelope method.Suprapubic drainage was performed in the pubic group and transurethral drainage was performed in the urethra group.The postoperative recovery indicators(including postoperative drainage time,gastrointestinal function recovery time and hospital stay time),postoperative pain changes from 1 to 3 days,postoperative complications(mainly including urinary tract infection,bladder spasm,anastomotic stenosis,urinary incontinence,etc.),and various surgical indicators were compared between the two groups.90 cases of elderly patients with prostate cancer admitted to our hospital from January 2017 to January 2019 were included in the study.All patients received robot-assisted radical prostatectomy.They were randomly divided into pubic group and urethral group by envelope method.Suprapubic drainage was performed in the pubic group,and transurethral drainage was performed in the urethral group.Postoperative recovery indexes(including postoperative drainage time,gastrointestinal function recovery time and hospital stay),postoperative pain changes from 1 to 3 days,and postoperative complications(mainly including urinary tract infection,bladder spasm,anastomotic stenosis,urinary incontinence,etc.),the surgical indicators,were compared between the two groups.Results:Postoperative drainage time and gastrointestinal function recovery time were significantly shorter in the pubic group than in the urethra group(all P<0.05).VAS scores of the pubic bone group were significantly lower than those of the urethra group 1,2 and 3 days after operation(all P<0.05).The total incidence of postoperative complications in the pubic group was significantly lower than that in the urethra group(P<0.05).The rate of timely urine control 3 months after operation in pubic group was higher than that in urethra group(P<0.05).The postoperative drainage time and recovery time of gastrointestinal function in the pubic group were significantly shorter than those in the urethral group(P<0.05).VAS scores of the pubic group were significantly lower than those of the urethral group at 1d,2d and 3d after surgery(all P<0.05).The total incidence of postoperative complications in the pubic group was significantly lower than that in the urethral group(P<0.05).The timely urinary continence rate of the pubic bone group was higher than that of the urethra group 3 months after surgery(P<0.05).Conclusion:Compared with transurethral drainage,robot-assisted suprapubic drainage after radical resection of senile prostate cancer has a better effect,can significantly reduce postoperative pain,reduce the risk of postoperative complications,and is of good safety,which is worthy of clinical application.Compared with transurethral drainage,suprapubic drainage assisted by robots after radical prostatectomy for elderly patients with prostate cancer is more effective,which can significantly reduce postoperative pain and reduce the risk of postoperative complications.It is safe and worthy of clinical application.