腹腔镜前列腺癌根治术时对腺体突向膀胱的优化处理:附视频  

The optimized treatment of prostate gland protruding to bladder in laparoscopic radical prostatectomy

作　　者：曹达龙[1,2] 叶定伟[1,2] 戴波[1,2] 张海梁[1,2] 沈益君[1,2] 朱一平[1,2] 施国海[1,2] 马春光[1,2] 肖文军[1,2] 秦晓健[1,2] 林国文[1,2] 朱耀[1,2] 

机构地区：[1]复旦大学附属肿瘤医院泌尿外科,上海200032 [2]复旦大学肿瘤学系,上海200433

出　　处：《中华腔镜泌尿外科杂志（电子版）》2015年第5期4-6,共3页Chinese Journal of Endourology(Electronic Edition)

基　　金：国家自然科学基金(81302213);国家自然科学基金(81272837);复旦大学附属肿瘤医院院级基金(YJ201206)

摘　　要：目的总结和介绍腹腔镜前列腺癌根治术时处理前列腺腺体突向膀胱（前列腺中叶突向膀胱超过1cm）的经验和技巧，评价其临床价值。方法8例前列腺腺体突向膀胱的前列腺癌患者均接受前列腺癌根治术。术中先游离膀胱颈两侧分别至3点和9点，再剥离尿道隧道，然后将前列腺中叶从尿道开口中提起，最后从前列腺中叶表面剥离膀胱黏膜和靠近膀胱后壁分离前列腺。分析该方法的成功率、完成时间和并发症。结果8例患者均成功实施了前列腺癌根治术，完全分离膀胱颈与前列腺所需时间15～36min，平均27min；手术总时间90～180min，平均131min。术中无输尿管口损伤，术后无尿漏、无手术切缘阳性等并发症发生。结论腹腔镜前列腺癌根治术中采用优化的手术技巧处理腺体突向膀胱，方法简单，效果确切，值得在临床推广应用。To summarize and introduce our skills and experiences of treatment of prostate gland protruding to bladder in laparoscopic radical prostatectomy （LRP） and evaluate its clinical value. Methods Eight cases of prostate cancer patients with gland protruding to bladder were treated by LRP. Firstly, dissecting bladder neck from the place of 12：00 to 3：00 and to 9：00, then stripping urethra tunnel. Secondly, lifting the mid-gland of prostate. Finally, isolating bladder mucosa from the surface of prostate mid-gland and then separating between bladder back-wall and prostate. The success rate, operative time and complications of our operational method were analyzed in detail. Reaulys All patients in this study underwent successfully by LRP. The time of separating between bladder neck and prostate ranged from 15 min to 36 min, mean time 27 min. And the total operative time was 90~180 min with mean time 131 min. Ureterostoma injury during operation, and postoperative urinary leakage and positive surgical margin were not occurred. Comchsions It was an simple and effective method of using our operative skills to handle prostate gland protruding to bladder in LRP.

关 键 词：前列腺肿瘤 腹腔镜 优化处理 

分 类 号：R737.25[医药卫生—肿瘤]