影响前列腺癌根治术后控尿的解剖学、手术及技术因素。
Anatomical, surgical and technical factors influencing continence after radical prostatectomy.
作者信息
Arroyo Carlos, Martini Alberto, Wang Joanna, Tewari Ashutosh K
机构信息
Department of Urology, Hospital Ángeles Puebla, Universidad Anahuac, School of Medicine, Puebla, c.p.72820, Puebla, Mexico.
Department of Urology, Icahn School of Medicine at Mount Sinai, New York, USA.
出版信息
Ther Adv Urol. 2019 Jan 8;11:1756287218813787. doi: 10.1177/1756287218813787. eCollection 2019 Jan-Dec.
Abstract
Radical prostatectomy (RP) is the most frequent treatment with curative intent performed for prostate cancer to date. Different surgical approaches (perineal, transperitoneal, and extraperitoneal) and techniques (laparoscopic and robot assisted) have been described to increase the efficiency and potentially diminish the postoperative complications of this procedure. The aim of this narrative review is to investigate and define the factors that influence postprostatectomy urinary continence. We highlighted the anatomical landmarks and the modifications of surgical techniques aimed at improving the continence rates and thus, patient quality of life. After RP, the long-term continence rates range from 84% to 97%. In order to achieve good continence rates, a careful dissection along with meticulous anatomical reconstruction is required. To this end, a detailed knowledge of the periprostatic anatomy is mandatory.
摘要
根治性前列腺切除术（RP）是迄今为止针对前列腺癌最常实施的具有治愈意图的治疗方法。为提高该手术的效率并可能减少术后并发症，人们描述了不同的手术入路（会阴、经腹和腹膜外）和技术（腹腔镜和机器人辅助）。本叙述性综述的目的是研究和确定影响前列腺切除术后尿失禁的因素。我们强调了旨在提高控尿率从而改善患者生活质量的解剖学标志和手术技术的改进。RP术后，长期控尿率在84%至97%之间。为了获得良好的控尿率，需要进行仔细的解剖分离以及细致的解剖重建。为此，必须详细了解前列腺周围的解剖结构。
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