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重建技术对机器人辅助腹腔镜前列腺切除术中控尿功能的影响:长尿道残端与前悬吊缝合的新型组合

Effect of Reconstructive Techniques on Continence in Robot-Assisted Laparoscopic Prostatectomy: Novel Combination of Long Urethral Stump and Anterior Suspension Suture.

作者信息

Karabulut Ibrahim, Yilmazel Fatih Kursat, Yilmaz Ali Haydar, Celik Erkan Cem, Ceylan Onur, Ozkaya Fatih, Adanur Senol, Polat Ozkan

机构信息

Department of Urology, Health Sciences University Training and Research Hospital, Erzurum, Turkey.

Clinic of Urology, Bilecik State Hospital, Bilecik, Turkey.

出版信息

Eurasian J Med. 2020 Feb;52(1):57-60. doi: 10.5152/eurasianjmed.2020.19234.

Abstract

OBJECTIVE

To investigate the effects of the novel combination of a long urethral stump and anterior suspension suture in patients who underwent Robot-Assisted Laparoscopic Prostatectomy (RALP) for localized prostate cancer.

MATERIALS AND METHODS

Of the 40 participating patients, 20 did not undergo any reconstructive technique, whereas the remaining 20 patients underwent reconstructive technique that included the combination of long urethral stump and anterior suspension suture. Body mass index (BMI) (kg/m), age, preoperative prostate-specific antigen (PSA) levels, prostate volume, Gleason score, D'Amico risk class, clinical stage, operation type and the application of either perioperative or postoperative reconstructive techniques, and the duration of catheterization were the parameters investigated. Continence rate was measured in the 3, 6, and 12 month after the removal of the catheter. Both techniques were compared statistically.

RESULTS

The control and reconstructive groups each comprised 20 patients. Between the groups, no statistically significant differences were observed in age, BMI, American Society of Anesthesiologists class, risk group, prostate weight, perioperative PSA, duration of surgery, duration of hospitalization, surgical margins, and the total amount of bleeding (p>0.05). Continence rate was significantly higher in the reconstructive group in the 3 and 6 months compared with the control group (p<0.05).

CONCLUSION

The combination of anterior suspension suture and long urethral stump contributed to early improvement in the continence rates.

摘要

目的

探讨长尿道残端与前悬吊缝合术的新型联合应用对接受机器人辅助腹腔镜前列腺切除术(RALP)治疗局限性前列腺癌患者的影响。

材料与方法

40例参与研究的患者中,20例未接受任何重建技术,其余20例患者接受了包括长尿道残端与前悬吊缝合术联合应用的重建技术。研究参数包括体重指数(BMI)(kg/m)、年龄、术前前列腺特异性抗原(PSA)水平、前列腺体积、Gleason评分、D'Amico风险分级、临床分期、手术类型以及围手术期或术后重建技术的应用情况,还有导尿持续时间。在拔除导尿管后的3个月、6个月和12个月测量控尿率。对两种技术进行统计学比较。

结果

对照组和重建组各有20例患者。两组之间在年龄、BMI、美国麻醉医师协会分级、风险组、前列腺重量、围手术期PSA、手术持续时间、住院时间、手术切缘和总出血量方面均未观察到统计学上的显著差异(p>0.05)。与对照组相比,重建组在3个月和6个月时的控尿率显著更高(p<0.05)。

结论

前悬吊缝合术与长尿道残端的联合应用有助于早期提高控尿率。

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