尿道"管状"保留及重建技术在机器人辅助腹腔镜前列腺根治性切除术中的应用

目的 探讨尿道"管状"保留及重建技术在机器人辅助腹腔镜前列腺根治性切除术(RALRP)中应用的安全性和有效性.方法 回顾性分析由单一术者(张旭)于2014年10月至2014年12月施行57例采用该技术的RALRP.对比围手术期资料以及术后随访情况.结果 57例患者均手术成功.平均手术操作时间147.4min.平均出血量114.8mL.术后拔除引流管平均时间5d,术后通气平均时间2d,术后患者平均住院时间7d.病理报告提示前列腺底部切缘阳性1例,前列腺尖部切缘阳性2例.随访手术后三个月有1例患者发生尿失禁.结论 尿道"管状"保留及重建技术用于机器人辅助腹腔镜前列腺根治性切除术中的安全性好,能更好的保留膀胱颈口,有利于膀胱和尿道的重建,降低了患者术后尿失禁的发生率.

Application of tubulous dissection and reconstruction of urethra in robotic-assisted laparoscopic radical prostatectomy

Objectives To evaluate the feasibility and safety of tubulous dissection and reconstruction of urethra in robotic-assisted laparoscopic radical prostatectomy (RALRP).Methods The complete clinical and follow-up data of 57 cases using this tubulous technique was reviewed retrospectively.Results All 57 cases received operation successfully.Average operative time was 147.4 min with an estimated blood loss of 114.8ml.The drain tube was removed on postoperative day 5.The average time of bowel recoverment was 2d with an average 7d of postoperative hospitalization time.There was one and two cases of positive margin on the bladder neck and tip of prostate, respectively.Only one case suffered from mild urinary incontinence three months after surgery.Conclusions Tubulous dissection and reconstruction of urethra technique was safe in RALRP.It can precisely preserve the bladder neck opening with better anastomosis of bladder neck and urethra, thus reducing the incontinence of the patients after surgery.