Gould D L, Borer J
Department of Surgery, John Peter Smith Hospital, Fort Worth, Texas, USA.
J Urol. 1996 Mar;155(3):1008-10.
We demonstrated the efficiency, efficacy and effectiveness of the endoscopic gastrointestinal anastomosis (GIA) stapler in radical retropubic prostatectomy.
A total of 21 patients with organ confined prostate cancer on preoperative staging underwent radical retropubic prostatectomy. During these procedures we analyzed the applicability and efficacy of the endoscopic GIA vascular stapler to effect ligation, division and stapling of the dorsal vein complex and lateral pedicles of the prostate. This group was compared to 7 controls in whom we performed surgery for organ confined disease, using the stapler solely for the lateral prostatic pedicles or not at all depending on availability. One patient with localized muscle invasive transitional cell carcinoma of the bladder underwent radical cystectomy using the endoscopic GIA stapler in a sequential fashion to ligate and divide all pedicles of the specimen.
Mean total operative time was 2 hours (range 1 hour 40 minutes to 2 hours 50 minutes) and average estimated blood loss was 400 cc. All patients were discharged from the hospital on postoperative day 3. To date 17 of the 21 patients are continent and 6 are potent.
Although not designed to replace the standard approach to radical retropubic prostatectomy, we believe that this technique makes the procedure easier and more approachable in the hands of the less experienced surgeon.
我们展示了内镜下胃肠吻合器（GIA）在耻骨后根治性前列腺切除术中的效率、效能和有效性。
共有21例术前分期为器官局限性前列腺癌的患者接受了耻骨后根治性前列腺切除术。在这些手术过程中，我们分析了内镜GIA血管吻合器在结扎、离断和吻合前列腺背静脉复合体及侧蒂方面的适用性和效能。将该组与7例对照组进行比较，对照组患者同样为器官局限性疾病，根据吻合器的可用性，仅对前列腺侧蒂使用吻合器或根本不使用。1例局限性肌肉浸润性膀胱移行细胞癌患者采用内镜GIA吻合器依次结扎和离断标本的所有蒂部，进行了根治性膀胱切除术。
平均总手术时间为2小时（范围为1小时40分钟至2小时50分钟），平均估计失血量为400毫升。所有患者均在术后第3天出院。迄今为止，21例患者中有17例控尿，6例性功能保留。
虽然该技术并非旨在取代耻骨后根治性前列腺切除术的标准方法，但我们认为，在经验较少的外科医生手中，该技术使手术更简便、更易于操作。
