| 李绍江,张士更,张楠.保留膀胱颈近端尿道在前列腺癌根治术后尿控功能中的作用[J].浙江中西医结合杂志,2018,28(5): |
| 保留膀胱颈近端尿道在前列腺癌根治术后尿控功能中的作用 |
| Effect of bladder neck preservation during laparoscopic radical prostatectomy on early urinary continence |
| 投稿时间：2017-11-29 修订日期：2018-03-23 |
| DOI： |
| 中文关键词: 腹腔镜前列腺癌根治术 保留膀胱颈 尿控 |
| 英文关键词:Laparoscopic radical prostatectomy bladder neck preservation urinary continence |
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| 中文摘要: |
| 目的 探讨腹腔镜前列腺癌根治术中保留膀胱颈近端尿道的手术技巧、可行性及对术后尿控功能的作用。方法 收集我院2015年8月至2017年1月行腹膜外腹腔镜前列腺癌根治术病例43例，将其中成功保留保留膀胱颈近端尿道的患者24例分为观察组，未能保留膀胱颈近端尿道的19例患者分为对照组。比较两组在手术时间、出血量、手术切缘阳性率，使用国际尿控协会调查问卷评估比较拔除尿管后即刻、1月、3月时尿控率。结果 43例手术均顺利完成，未出现明显并发症，观察组与对照组在手术时间、术中出血量、手术切缘阳性率、住院时间无明显差异（123.64±23.45min比117.52±32.47min、110.35±98.77ml比131.43±78.35ml、8.33%比5.26%、4.25±2.32d比5.36±2.15d，P均>0.05）。保留膀胱颈近端尿道组在术后拔除尿管后即刻、术后1月、术后3月尿控功能恢复率差异显著高于对照组[79.17%（19/24）比42.11%（8/19）、87.50%（21/24）比68.42（13/19）、95.83（23/24）比78.95（15/19），P均<0.05]。结论 腹腔镜前列腺癌根治术中保留膀胱颈近端尿道安全可行,对术后尿控功能的早期恢复具有显著作用。 |
| 英文摘要: |
| Objective To investigate the surgical techniques, feasibility and postoperative urinary control function in preserving the proximal urethra of the bladder neck during laparoscopic radical prostatectomy. Methods Fourty-three patients with prostate cancer were enrolled in our hospital from August 2015 to January 2017，Twenty-four patients successfully preservated the proximal urethra of the bladder neck were enrolled as observation group and nineteen patients who failed to retain the proximal urethra of bladder neck as control group. Comparing the two groups in the operation time, intraoperative blood loss, the positive rate of surgical margins, assessment of the urine control function immediately after removal of the catheter, and at 1, 3 months. Results All the operations were successful without significant complication.There were no significant differences between operation observation group and control group in operation time, intraoperative blood loss, positive surgical margin and hospitalization time (123.64 ± 23.45min vs 117.52 ± 32.47min , 110.35 ± 98.77ml vs 131.43 ± 78.35ml, 8.33% vs 5.26%, 4.25 ± 2.32d vs 5.36 ± 2.15d, all P> 0.05).However, the rate of urinary control recovery after surgery was significantly different in the time of the catheter was removed immediately, the first month and the third month [79.17% (19/24) vs 42.11% (8/19), 87.50% (21/24) vs 68.42% (13/19), 95.83 (23/24) vs 78.95 (15/19), all P <0.05]. Conclusion Bladder neck preservation during laparoscopic radical prostatectomy is feasible and has priority in early urinary continence. |
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