保留膀胱颈对机器人辅助腹腔镜前列腺根治性切除术后早期尿控恢复的研究

Effect of bladder neck preservation on early urinary control recovery after robotassisted laparoscopic radical prostatectomy

目的探讨膀胱颈保留技术应用于机器人辅助腹腔镜根治性前列腺切除术(robot-assisted laparoscopic radical prostatectomy,RALP)中对患者术后早期尿控恢复的有效性。方法 回顾性分析2020年5月-2022年8月于吉林大学白求恩第三医院行机器人辅助根治性前列腺切除术53例,其中保留膀胱颈患者31例为研究组,未保留膀胱颈患者22例为对照组。收集患者年龄、前列腺体积、术前PSA、手术时长、出血量、切缘阳性率、引流管拔除时间、导尿管留置时间、术后病理分期、Gleason评分、术后并发症、术后尿垫使用量等资料,并进行统计学分析。结果 经过非参数秩和检验,研究组与对照组术后即刻、术后1月、术后2月、术后3月尿垫使用量差异有统计学意义(P <0.05);术后6月尿垫使用量差异无统计学意义(P=0.090)。结论 在不影响肿瘤切缘及手术疗效的前提下,机器人辅助前列腺根治性切除术中保留膀胱颈可提升术后即刻尿控率及早期尿控率,优化患者生存质量。

Objective To explore the effectiveness of bladder neck preservation technique in robot-assisted laparoscopic radical prostatectomy(RALP)for early postoperative urinary control recovery.Methods The clinical data of 53 patients who underwent robot-assisted radical prostatectomy in China-Japan Union Hospital of Jilin University from May 2020 to August 2022 were analyzed retrospectively.Among them,31 patients with bladder neck preservation were as the study group,and 22 patients without bladder neck preservation were as the control group.The patient's age,prostate volume,preoperative PSA,operation time,bleeding volume,positive margin rate,drainage tube removal time,time of indwelling urinary catheter,postoperative pathological stage,Gleason score,postoperative complications,postoperative urinary pad usage,and other data were collected and statistically analyzed.Results After nonparametric rank sum test,there was statistically significant difference in the use of urinary pads between the study group and the control group immediately after surgery,at 1 month after surgery,2 months after surgery,and 3 months after surgery(P<0.05).There was no statistically significant difference in the use of urinary pads at 6 months after surgery(P-0.090).Conclusion On the premise of not affecting the tumor margin and surgical eficacy,bladder neck preservation during robot-assisted radical prostatectomy can improve the immediate urinary control rate and early urinary control rate after surgery,and improve the quality of life of patients.