根治性会阴前列腺切除术中的直肠损伤
Rectal injury in radical perineal prostatectomy.
作者信息
de Arruda Homero Oliveira, Cury Jose, Ortiz Valdemar, Srougi Miguel
机构信息
Department of Urology, São Paulo Hospital, Federal University of São Paulo, Paulista School of Medicine, São Paulo, Brazil.
出版信息
Tumori. 2007 Nov-Dec;93(6):532-5. doi: 10.1177/030089160709300602.
OBJECTIVE
To report our experience in treating patients with rectal injury with radical perineal prostatectomy.
METHODS
Medical charts of 176 patients submitted to radical perineal prostatectomy from 1996 to 2005 were reviewed to identify rectal problems. A review of rectal injury in prostatectomy is provided.
RESULTS
Of 176 patients who underwent radical perineal prostatectomy, 10 (5.7%) had rectal injury and 4 (2.3%) presented rectal fistula. Two (1.1%) patients were submitted to colostomy. We discuss how to avoid and treat the complications.
CONCLUSIONS
There is a real risk of rectal injury during radical perineal prostatectomy, particularly during the learning period or if the approach is not often performed. Fistula might occur, but colostomy is actually unnecessary and rare. A better understanding of the perineal anatomy and knowledge about the technique is recommended before practicing radical perineal prostatectomy.
目的
报告我们在根治性会阴前列腺切除术中治疗直肠损伤患者的经验。
方法
回顾1996年至2005年接受根治性会阴前列腺切除术的176例患者的病历，以确定直肠问题。提供了前列腺切除术中直肠损伤的综述。
结果
在176例行根治性会阴前列腺切除术的患者中，10例（5.7%）发生直肠损伤，4例（2.3%）出现直肠瘘。2例（1.1%）患者接受了结肠造口术。我们讨论了如何避免和治疗这些并发症。
结论
根治性会阴前列腺切除术期间存在直肠损伤的实际风险，尤其是在学习阶段或手术操作不频繁时。可能会发生瘘，但实际上结肠造口术既不必要也很少见。在进行根治性会阴前列腺切除术之前，建议更好地了解会阴解剖结构并掌握相关技术知识。
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