机器人辅助单孔腹腔镜前列腺根治性切除术中保留膀胱颈技术对术后尿控的效果研究(附视频)

Effect of bladder neck preservation technique on postoperative urinary continence after single-port robot-assisted laparoscopic radical prostatectomy(with video)

目的:为了评估保留膀胱颈技术应用在机器人辅助单孔腹腔镜前列腺根治性切除术中对于围手术期结果及术后尿控的影响。方法:回顾性分析2020年1月—2020年12月于南京中医药大学附属医院行机器人辅助单孔腹腔镜前列腺根治性切除术的69例患者临床资料。其中33例为对照组(膀胱颈未完整保留),36例为观察组(完整保留膀胱颈),对患者的临床基本数据和围手术期结果进行比较。结果:比较两组患者的临床资料,差异无统计学意义(P>0.05)。比较对照组与观察组的手术时间和出血量,差异无统计学意义(P>0.05);而观察组在术后引流管放置时间和住院时间方面均更短,差异具有统计学意义(P<0.05)。术后尿控方面,观察组较对照组术后尿控功能恢复快,差异具有统计学意义(P<0.05),且观察组术后3、6、12个月的尿控恢复率均较高。结论:完整保留膀胱颈技术应用于机器人辅助单孔腹腔镜前列腺根治性切除术,有益于加快术后康复,帮助患者快速恢复术后尿控功能。

Objective:To assess the clinical effect of bladder neck preservation technique on perioperative outcomes and postoperative urine continence after robot-assisted laparoendoscopic single-site radical prostatecomy(R-LESS-RP).Methods:The clinical data of 69 patients who underwent R-LESS-RP in the Affiliated Hospital of Nanjing University of Chinese Medicine from January 2020 to December 2020 were analyzed retrospectively.Among them,33 cases were divided into the control group(bladder neck was not completely preserved)and 36 cases into the observation group(complete preservation of the bladder neck).The basic clinical data and perioperative results of the two groups were compared.Results:There was no significant difference in clinical data between the two groups(P>0.05).There was no significant difference in operative time and blood loss between the control group and the observation group(P>0.05).The time of postoperative drainage tube placement and hospital stay in the observation group were shorter,and the difference was statistically significant(P<0.05).In terms of postoperative urinary continence,the urinary continence of the observation group recovered faster than that of the control group,and the difference was statistically significant(P<0.05).The recovery rate of urinary continence was higher in the observation group than that in the control group at 3,6 and 12 months after surgery.Conclusion:The application of complete bladder neck preservation technique in R-LESS-RP is beneficial to accelerate postoperative rehabilitation and could help patients quickly recover from postoperative urinary continence.