Tunc Lutfi, Akin Yigit, Gumustas Huseyin, Ak Esat, Peker Tuncay, Veneziano Domenico, Guneri Cagri
Department of Urology, Gazi University School of Medicine, Ankara, Turkey.
Urol Int. 2016;96(3):260-7. doi: 10.1159/000443674. Epub 2016 Feb 9.
To describe our surgical technique for dissecting the apex of prostate during robotic-assisted laparoscopic radical prostatectomy (RALP) and detailed surgical anatomy of prostate including relationship between urethra and dorsal vein complex with apex.
In retrospective view of prospective collected data, 73 patients underwent RALP between December 2012 and September 2014. Surgical anatomy of prostate was revealed in all procedures. Quality of life (QoL) scores were assessed before, immediately after catheter removal, and 1 month after surgery. We divided urinary continence into 3 groups, as very early continence; continence at time of urethral catheter removal, early continent; and continence 1 month after surgery. The rest of the patients were accepted as continence.
The mean follow-up was 10.2 ± 5.4 months and mean age was 61.5 ± 6.6. Maximum protection of urethra could be provided in all. Mean catheter removal was 8.9 ± 1.7 days, and all patients were continent at the time of catheter removal. QoL scores before RALP could be protected after surgery (p = 0.2). Neither conversion to open/conventional laparoscopic surgery nor complications related with bladder neck were detected.
Our surgical technique can be a strong candidate for being a surgical technique for preserving urethra and very early continence could be provided after surgery.
描述我们在机器人辅助腹腔镜根治性前列腺切除术(RALP)中解剖前列腺尖部的手术技术,以及前列腺的详细手术解剖结构,包括尿道与背静脉复合体与尖部的关系。
回顾性分析前瞻性收集的数据,2012年12月至2014年9月期间73例患者接受了RALP。所有手术均揭示了前列腺的手术解剖结构。在术前、拔除导尿管后即刻以及术后1个月评估生活质量(QoL)评分。我们将尿失禁分为3组,即极早期控尿;拔除尿道导尿管时控尿,早期控尿;以及术后1个月控尿。其余患者视为控尿。
平均随访时间为10.2±5.4个月,平均年龄为61.5±6.6岁。所有人均能最大程度地保护尿道。平均拔管时间为8.9±1.7天,所有患者在拔管时均能控尿。术后RALP术前的QoL评分得以保留(p = 0.2)。未发现转为开放/传统腹腔镜手术的情况,也未发现与膀胱颈相关的并发症。
我们的手术技术有望成为一种保留尿道的手术技术,术后可实现极早期控尿。