Golabek Tomasz, Wiatr Tomasz, Przydacz Mikolaj, Bukowczan Jakub, Dudek Przemyslaw, Sobczynski Robert, Golabek Katarzyna, Chłosta Piotr L
Department of Urology, Collegium Medicum at the Jagiellonian University, Cracow, Poland.
Department of Endocrinology and Diabetes Mellitus, Diabetes Resource Centre, North Tyneside General Hospital, North Shields, United Kingdom.
Cent European J Urol. 2015;68(3):296-301. doi: 10.5173/ceju.2015.617. Epub 2015 Sep 7.
Creation of a watertight vesicourethral anastomosis is a challenging and time-consuming procedure. In an attempt to simplify this critical step of radical prostatectomy we have developed a laparoscopic running single suture technique and presented preliminary results previously. Here we report our two-year experience with the Chlosta's single running suture technique.
Between January 2013 and June 2014, 60 consecutive patients underwent laparoscopic radical prostatectomy with a running vesicourethral anastomosis using our modified technique for clinically localized prostate cancer. Analyses of the patients' data from a prospectively maintained database with respect to perioperative characteristics, morbidity and urinary continence was performed.
The mean anastomotic time was 10.2 min. There was no clinically significant anastomotic leakage observed. Only 3 patients developed perioperative morbidity, but none of them was classified as major. Bladder neck contracture occurred in only one man and it was managed endoscopically. Overall continence rates at 3, 6, 12, and 18 months were 73%, 85%, 96.7%, and 95%, respectively, and 76.8%, 89.3%, 96.4%, and 96.4%, respectively when analysis was limited to those without adjuvant radiotherapy.
Obtained results confirm our initial observation from the preliminary report and support the use of our single running suture for the vesicourethral anastomosis in LRP.
创建一个水密的膀胱尿道吻合是一项具有挑战性且耗时的操作。为了简化根治性前列腺切除术中这一关键步骤，我们开发了一种腹腔镜连续单缝合法，并已在之前报告了初步结果。在此，我们报告我们使用克洛斯塔单连续缝合法的两年经验。
2013年1月至2014年6月期间，60例连续患者接受了腹腔镜根治性前列腺切除术，采用我们改良的技术进行连续膀胱尿道吻合，用于临床局限性前列腺癌。对前瞻性维护数据库中患者的数据进行围手术期特征、发病率和尿失禁方面的分析。
平均吻合时间为10.2分钟。未观察到具有临床意义的吻合口漏。仅3例患者发生围手术期并发症，但均未被归类为严重并发症。仅1例男性发生膀胱颈挛缩，通过内镜处理。3、6、12和18个月时的总体控尿率分别为73%、85%、96.7%和95%，若仅分析未接受辅助放疗的患者，控尿率分别为76.8%、89.3%、96.4%和96.4%。
获得的结果证实了我们初步报告中的最初观察结果，并支持在腹腔镜根治性前列腺切除术中使用我们的单连续缝合法进行膀胱尿道吻合。
