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解剖重建技术在机器人辅助腹腔镜根治性前列腺切除术中对尿道周围结构的应用。

Application of anatomic reconstruction technique for periurethral structure in robotic assisted laparoscopic radical prostatectomy.

作者信息

Li Haichang, Lu Dongning, Hu Yuning, Mou Yixuan, Zhang Dahong, Liu Zhenghong

机构信息

Urology & Nephrology Center, Department of Urology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.

出版信息

Front Oncol. 2023 Jul 25;13:1221217. doi: 10.3389/fonc.2023.1221217. eCollection 2023.

Abstract

OBJECTIVE

To investigate the outcome of patients underwent anatomic periurethral reconstruction during robotic assisted laparoscopic radical prostatectomy (RARP).

MATERIALS AND METHODS

During August 2016 to May 2018, periurethral structure anatomic reconstruction was performed during RARP in 58 consecutive patients. The control group consists of another 50 patients had no reconstruction procedure during RARP. Perioperative data of these patients were collected retrospectively, including operation time, anastomosis time, intraoperative blood loss, duration of indwelling catheter, length of hospital stay, complications, postoperative pathology, and continence outcome at 1,3,6 and 12 months.

RESULTS

All cases were successfully performed without conversion to open or laparoscopic surgery. There were no major intraoperative or postoperative complications.The percentage of patients maintain continence in the reconstruction group versus non-reconstruction group: At 1 month 84.5% (49/58)versus 70.0% (35/50), at 3 months 89.7% (52/58)versus 78.0% (39/50), at 6 months 91.3% (53/58)versus 86.0% (43/50) and 1 year after surgery 100.0% (58/58)versus 96.0% (48/50). Reconstruction group showed better continence outcome in 1 and 3 months (P<0.05). There is no statistical differences in 6 month and 1 year.

CONCLUSION

Anatomic reconstruction of periurethral structure during RARP is safe and feasible with reduced duration of indwelling catheter and better continence outcome.

摘要

目的

探讨在机器人辅助腹腔镜根治性前列腺切除术(RARP)期间进行尿道周围解剖重建的患者的预后。

材料与方法

2016年8月至2018年5月期间,连续58例患者在RARP期间进行了尿道周围结构解剖重建。对照组由另外50例在RARP期间未进行重建手术的患者组成。回顾性收集这些患者的围手术期数据,包括手术时间、吻合时间、术中出血量、留置导尿管时间、住院时间、并发症、术后病理以及术后1、3、6和12个月时的控尿结果。

结果

所有病例均成功完成,未转为开放手术或腹腔镜手术。术中及术后均无重大并发症。重建组与非重建组患者保持控尿的百分比:术后1个月时分别为84.5%(49/58)和70.0%(35/50),3个月时分别为89.7%(52/58)和78.0%(39/50),6个月时分别为91.3%(53/58)和86.0%(43/50),术后1年时分别为100.0%(58/58)和96.0%(48/50)。重建组在术后1个月和3个月时控尿结果更好(P<0.05)。6个月和1年时无统计学差异。

结论

RARP期间尿道周围结构的解剖重建是安全可行的,可缩短留置导尿管时间并获得更好的控尿结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a78f/10407552/87d29b0440d8/fonc-13-1221217-g001.jpg

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