Effect of laparoscopic radical prostatectomy reserving partial proximal prostate urethra on 36 cases of prostate cancer
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摘要: 目的 观察保留部分近端前列腺部尿道的腹腔镜前列腺癌根治术对早期尿失禁的影响,探讨其临床应用价值。 方法 选择绍兴市人民医院于2013年6月—2015年3月收治的72例前列腺癌患者,均符合手术指证,按照配对分组法分为2组,每组36例,对照组采用非保留部分近端前列腺部尿道的前列腺癌根治术,观察组采取保留部分近端前列腺部尿道的腹腔镜前列腺癌根治术治疗,分离前列腺尖部及尿道交界处,术者于前列腺尖部使用小纱布分离玻璃球剥离出0.5~1.0 cm长的尿道。2组患者术后均行抗感染治疗。72例患者均随访12个月。比较2组早期尿失禁的发生情况。 结果 观察组患者手术时间、术中出血量、住院时间及导尿管留置时间分别为(145.2±42.7) min、(415.2±91.2) ml、(11.2±2.2) d及(15.3±2.6) d,与对照组(139.8±35.8) min、(398.5±98.6) ml、(10.9±1.9) d及(14.5±2.5) d比较差异均无统计学意义,均P>0.05。观察组术后1、3、6个月达到完全尿控率分别为19例(52.8%)、31例(86.1%)、32例(88.9%),均显著高于对照组的8例(22.2%)、16例(44.4%)、25例(69.4%),P<0.05。观察组术后1、3、6个月ICIQ-SF评分均显著低于对照组,P<0.05。 结论 保留部分近端前列腺部尿道的腹腔镜前列腺癌根治术患者早期尿控效果更佳,具有重要的临床价值。Abstract: Objective To observe the effect of retention laparoscopic radical prostatectomy with reserving partial proximal prostate urethra on the early urinary incontinence,and to explore its clinical value. Methods Seventy-two cases of prostate cancer in our hospital from June,2013 to March,2015 were enrolled in this study.There were consistent with surgery evidence.According with the paired grouping method,they were divided into two groups with 36 cases in each group;the control group took the non-retained part of the proximal prostatic urethra prostatectomy while the observation group accepted retention laparoscopic radical prostatectomy with reserving partial proximal prostate urethra.Separation of the tip of the prostate and the urethra at the junction,the surgeon at the tip of the prostate by using small gauze to separate the glass ball from the 0.5-1.0 cm long urethra.Both groups were treated with anti-infectious treatment.72 patients were followed up for 12 months to compare early urinary incontinence between two groups. Results The operation time,intraoperative bleeding,hospitalization time and the catheter indwelling time in the observation groups were (145.2±42.7)min,(415.2±91.2)ml,(11.2±2.2)d and (15.3±2.6)d,which had no significant statistical differences as compared with (139.8±35.8)min,(398.5±98.6)ml,(10.9±1.9)d and (14.5±2.5)d,P>0.05.At 1 months,3 months and 6 months after the operation in the observation group,the complete continence was seen in 19 cases(52.8%),31 cases(86.1%),32 cases(88.9%),which were significantly higher than those in the control group[8 cases(22.2%),16 cases(44.4%),25 patients(69.4%)],P<0.05.The ICIQ-SF score in the observation group after 1 month,3 months and 6 months were significantly lower than that of the control group,P<0.05. Conclusion The laparoscopic radical prostatectomy reserving partial proximal prostate urethra can improve the early urinary control of patients,which has important clinical value.
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Key words:
- Laparoscopic /
- Prostate cancer /
- Urinary incontinence
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