Lim Ju Hyun, Park Chang Myon, Kim Han Kwon, Park Jong Yeon
Department of Urology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
Korean J Urol. 2015 Jun;56(6):443-8. doi: 10.4111/kju.2015.56.6.443. Epub 2015 Jun 1.
To compare perioperative outcomes between running and interrupted vesicourethral anastomosis in open radical prostatectomy (RP).
The medical records of 112 patients who underwent open RP for prostate cancer at our institution from 2006 to 2008 by a single surgeon were retrospectively reviewed. Preoperative, intraoperative, and postoperative parameters were measured.
Of 112 consecutive patients, 62 patients underwent vesicourethral anastomosis by use of the running technique, whereas 50 patients underwent anastomosis with the interrupted technique. The groups did not differ significantly in age, body mass index, prostate-specific antigen, prostate volume, or pathologic findings. The intraoperative extravasation rate was significantly lower in the running group (8.1% vs. 24.0%, p=0.01). The mean anastomosis time was 15.1±5.3 and 19.3±4.6 minutes in the running and interrupted groups, respectively (p=0.04). The rates of postoperative extravasation were similar for both groups (6.4% vs. 10.0%, p=0.12). The duration of catheterization was significantly shorter in the running group (9.0±3.0 days vs. 12.9±6.4 days, p<0.01). The rate of urinary retention after catheter removal and the rate of bladder neck contracture were not significantly different between the two groups. The rate of urinary continence at 3, 6, 9, and 12 months after RP was also similar in both groups.
Both anastomosis techniques provided similar functional results and a similar rate of postoperative urine extravasation. However, running vesicourethral anastomosis decreased the rate of intraoperative extravasation and time for anastomosis, without increasing the risk of urinary retention or bladder neck contracture.
比较开放根治性前列腺切除术(RP)中连续缝合法与间断缝合法行膀胱尿道吻合术的围手术期结果。
回顾性分析2006年至2008年在我院由同一外科医生实施开放RP治疗前列腺癌的112例患者的病历。测量术前、术中和术后参数。
112例连续患者中,62例采用连续缝合法行膀胱尿道吻合术,50例采用间断缝合法。两组在年龄、体重指数、前列腺特异性抗原、前列腺体积或病理结果方面无显著差异。连续缝合组术中渗漏率显著较低(8.1%对24.0%,p = 0.01)。连续缝合组和间断缝合组的平均吻合时间分别为15.1±5.3分钟和19.3±4.6分钟(p = 0.04)。两组术后渗漏率相似(6.4%对10.0%,p = 0.12)。连续缝合组导尿时间显著较短(9.0±3.0天对12.9±6.4天,p<0.01)。两组拔除导尿管后尿潴留率和膀胱颈挛缩率无显著差异。RP术后3、6、9和12个月时两组的尿失禁率也相似。
两种吻合技术均能提供相似的功能结果和相似的术后尿液渗漏率。然而,连续膀胱尿道吻合术降低了术中渗漏率和吻合时间,且未增加尿潴留或膀胱颈挛缩的风险。