腹膜外三孔法腹腔镜前列腺癌根治术后尿控功能与术中保留膀胱颈的关系研究

Study on the relationship between urinary control function and bladder neck preservation after extraperitoneal three-hole laparoscopic radical prostatectomy

目的:研究腹膜外三孔法腹腔镜前列腺癌根治术(LRP)术后尿控功能与术中保留膀胱颈的关系。方法:选取2017年3月~2021年3月我院收治的行腹膜外三孔法LRP术的局限性前列腺癌患者82例,根据术中膀胱颈保留情况分为保留膀胱颈组42例和未保留膀胱颈组40例。比较两组围术期情况、术后病理分期、切缘阳性率,分析两组尿管拔除后1、3、6个月扩展前列腺癌复合指数(EPIC-UIN)评分、国际尿失禁咨询委员会尿失禁问卷简表(ICIQ-SF)评分、尿控恢复率及1 h尿垫测试结果。结果:两组围术期指标、术后病理分期、切缘阳性率无统计学差异。保留膀胱颈组术后1、3个月时EPIC-UIN评分和尿控恢复率显著高于未保留膀胱颈组,ICIQ-SF评分和1 h尿垫测试显著低于未保留膀胱颈组。结论:腹膜外三孔法LRP术中保留膀胱颈能有效促进患者术后早期尿控功能恢复。

Objective To study the relationship between urinary control function and bladder neck preservation after extraperitoneal three-hole laparoscopic radical prostatectomy (LRP).Methods 82 patients with localized prostate cancer who underwent extraperitoneal three-hole LRP were selected from March 2017 to March 2021 in our hospital,According to the conditions of bladder neck preservation,42 cases were divided into the bladder neck preservation group and 40 cases were divided into the bladder neck preservation group.The perioperative period,postoperative pathological stage and positive rate of edge cutting were compared between the two groups.The expanded prostate cancer index composite-urinary inventory (EPIC-UIN) score,international consultation committee on incontinence questionnaire short form (ICIQ-SF) score,urine control recovery rate and 1-h pad test results were analyzed at 1,3 and 6 months after catheter extraction.Results There were no significant differences in perioperative indexes,postoperative pathological stages and margin positive rate between the two groups.The EPIC-UIN score and the recovery rate of urinary control at 1 and 3 months after operation in the bladder neck preserving group were significantly higher than those in the bladder neck preserving group,and iciQ-SF score and 1-h pad test were significantly lower than those in the bladder neck preserving group.Conclusion The preservation of bladder neck during the operation of extraperitoneal three-hole LRP can effectively promote the early postoperative recovery of urinary control function.