Department of Urology, The First Affiliated Hospital of Soochow University, 215006 Suzhou, Jiangsu, China; Department of Urology, Wenling Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine, 317500 Wenling, Zhejiang, China.
Department of Urology, Wenling Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine, 317500 Wenling, Zhejiang, China.
Ann Ital Chir. 2024;95(4):737-743. doi: 10.62713/aic.3309.
The purpose of this study was to investigate the effect of laparoscopic lateral seminal vesicle approach to preserve the bladder neck during laparoscopic radical prostatectomy.
Between September 2020 and December 2022, we retrospectively analyzed patients with T1-T3b stage prostate cancer treated at our institution using the laparoscopic lateral seminal vesicle approach. We recorded the bladder neck preservation success rate, cystourethral anastomosis time, urinary catheter extraction time, length of hospital stay, and urinary control scores, including urine pad use, at 1 week, 1 month, and 3 months post-catheter removal. Adverse events included rectal injury, bladder injury, ureteral injury and positive surgical margins.
There were 56 patients (mean age 70 ± 5.8 years) The success rate of bladder neck preservation was 100%. The median cystourethral anastomosis time was 11 (9-14) minutes. The median postoperative hospital stay was 10 (9-11) days. The urinary continence rate was 83.9% (47/56) in 1 week, 89.3% (50/56) in 1 month and 98.2% (55/56) in 3 months. One patient developed adhesions caused by invasion of both seminal vesicles, which damaged the rectal wall.
The laparoscopic lateral seminal vesicle approach can preserve the bladder neck completely during laparoscopic radical prostatectomy, improving postoperative urinary continence, with a high rate of immediate urinary continence, and significantly improving patients' quality of life.
本研究旨在探讨腹腔镜侧索精囊入路在腹腔镜前列腺根治术中保留膀胱颈的效果。
2020 年 9 月至 2022 年 12 月，我们回顾性分析了在我院接受腹腔镜侧索精囊入路治疗的 T1-T3b 期前列腺癌患者。我们记录了膀胱颈保留成功率、膀胱尿道吻合时间、导尿管拔除时间、住院时间和术后 1 周、1 个月和 3 个月的尿控评分（包括尿垫使用情况）。不良事件包括直肠损伤、膀胱损伤、输尿管损伤和阳性切缘。
共有 56 例患者（平均年龄 70±5.8 岁），膀胱颈保留成功率为 100%。膀胱尿道吻合中位时间为 11（9-14）分钟。术后中位住院时间为 10（9-11）天。术后 1 周尿控率为 83.9%（47/56），1 个月为 89.3%（50/56），3 个月为 98.2%（55/56）。1 例患者因双侧索精囊侵犯导致粘连，损伤直肠壁。
腹腔镜侧索精囊入路可在腹腔镜前列腺根治术中完全保留膀胱颈，提高术后尿控率，即时尿控率高，显著提高患者生活质量。
