耻骨后根治性前列腺切除术后膀胱尿道吻合口狭窄：单中心经验
Vesicourethral anastomotic strictures after radical retropubic prostatectomy: the experience of a single institution.
作者信息
Kostakopoulos Athanasios, Argiropoulos Vassilios, Protogerou Vassilios, Tekerlekis Panagiotis, Melekos Michalis
机构信息
Department of Urology, Sismanoglion Hospital, University of Athens, Athens, Greece.
出版信息
Urol Int. 2004;72(1):17-20. doi: 10.1159/000075267.
OBJECTIVE
Stricture of the vesicourethral anastomosis remains a well-documented complication after radical retropubic prostatectomy.
MATERIALS AND METHODS
We performed a retrospective study of 294 patients with prostate cancer who underwent radical retropubic prostatectomy. Possible correlations between anastomotic stricture formation, tumor stage, positive surgical margins, number of anastomotic sutures, bladder neck preservation, urine leakage, previous prostate surgery and/or intraoperative blood loss were examined.
RESULTS
An anastomotic stricture was found in 18 cases (6%) requiring some kind of treatment. In 10 patients (56%), the bladder neck stricture occurred within 3 months after surgery, in 5 (28%) at 4-12 months after surgery and in 3 (16%) more than 12 months after surgery. Intraoperative blood loss (>1,000 ml) was found to be significantly correlated with urinary leakage (p < 0.001) and both correlated with anastomotic stricture formation (p < 0.005).
CONCLUSION
Excessive intraoperative blood loss (>1,000 ml) and urine leakage was found to be significantly correlated to the formation of anastomotic stricture following radical retropubic prostatectomy.
目的
耻骨后根治性前列腺切除术后膀胱尿道吻合口狭窄仍是一个有充分文献记载的并发症。
材料与方法
我们对294例行耻骨后根治性前列腺切除术的前列腺癌患者进行了一项回顾性研究。研究了吻合口狭窄形成、肿瘤分期、手术切缘阳性、吻合口缝线数量、膀胱颈保留、尿漏、既往前列腺手术和/或术中失血之间可能的相关性。
结果
18例（6%）患者发现吻合口狭窄，需要某种治疗。10例（56%）患者膀胱颈狭窄发生在术后3个月内，5例（28%）在术后4至12个月，3例（16%）在术后12个月以上。术中失血（>1000ml）与尿漏显著相关（p<0.001），且两者均与吻合口狭窄形成相关（p<0.005）。
结论
耻骨后根治性前列腺切除术后，术中失血过多（>1000ml）和尿漏与吻合口狭窄形成显著相关。
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