Mignard J P, Corbel L
Clinique Jeanne d'Arc, Saint-Brieue.
Prog Urol. 1994 Oct;4(5 Suppl 2):13-6.
Control of Santorini's plexus is one of the main difficulties of prostatectomy and total cystectomy. Two procedures allow easy control of this plexus: Perform a running haemostatic suture in the bladder neck, from one edge of the pelvic aponeurosis to the other. Apart from ensuring haemostatis by bringing Santorini's plexus together in the midline, this suture also provides excellent exposure of the prostate. Prepare the passage of the dissector at the prostatic apex by disrupting the fibrous tissue with a finger. The urethra is easily identified as it is intubated by the bladder catheter. The avascular plane between the urethra and Santorini's plexus is open to the finger and the dissector can be easily introduced into the correct plane. Section of the venous plexus is performed precisely to reveal the urethroprostatic junction.
控制Santorini丛是前列腺切除术和全膀胱切除术的主要难点之一。有两种方法可轻松控制该丛:在膀胱颈处从盆筋膜的一侧边缘到另一侧进行连续止血缝合。除了通过将Santorini丛在中线处并拢来确保止血外,这种缝合还能很好地暴露前列腺。用手指破坏纤维组织,在前列腺尖部准备好剥离器的通道。膀胱导管插入尿道时很容易识别尿道。尿道和Santorini丛之间的无血管平面可被手指分开,剥离器可轻松插入正确平面。精确切断静脉丛以显露尿道前列腺交界处。