Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
Int J Urol. 2012 Jul;19(7):683-7. doi: 10.1111/j.1442-2042.2012.02988.x. Epub 2012 Mar 8.
The aim of the present study was to assess the impact of a novel posterior reconstruction technique during robot-assisted laparoscopic prostatectomy on continence recovery. A total of 116 consecutive patients who received the novel posterior reconstruction (case group) were retrospectively compared with a cohort of 126 patients who did not receive posterior reconstruction (control group). The primary end-point was the duration of continence recovery (no pad use) after robot-assisted laparoscopic prostatectomy. The posterior reconstruction was obtained by opposing the median dorsal fibrous raphe to the posterior counterpart of the detrusor apron, rather than the Denonvilliers' fascia. The case group showed higher continence rates at all points of evaluation, which were 2 weeks (30.1% vs 19.8%), 1 month (58.4% vs 45.7%), 3 months (82.7% vs 70.5%) and 6 months postoperatively (95.3% vs 86.4%) (P = 0.007). Application of the novel posterior reconstruction technique, age and length of membranous urethra were significant variables for the complete recovery of continence on multivariable analysis. This study shows that the application of this novel PR technique significantly improves the recovery of continence in patients undergoing robot-assisted laparoscopic prostatectomy.
本研究旨在评估机器人辅助腹腔镜前列腺切除术中一种新的后重建技术对控尿恢复的影响。将接受新后重建（病例组）的 116 例连续患者与未接受后重建（对照组）的 126 例患者进行回顾性比较。主要终点是机器人辅助腹腔镜前列腺切除术后控尿恢复（无垫使用）的持续时间。后重建是通过将正中背纤维韧带到逼尿肌围裙的后对应物相对，而不是通过 Denonvilliers 筋膜来实现的。病例组在所有评估点的控尿率均较高，分别为术后 2 周（30.1%比 19.8%）、1 个月（58.4%比 45.7%）、3 个月（82.7%比 70.5%）和 6 个月（95.3%比 86.4%）（P = 0.007）。多变量分析显示，新的后重建技术的应用、年龄和膜状尿道长度是控尿完全恢复的显著变量。本研究表明，该新 PR 技术的应用显著改善了机器人辅助腹腔镜前列腺切除术患者的控尿恢复。
