腹腔镜前列腺癌根治性切除术后新发膀胱结石的回顾性研究  

Retrospective study of new bladder calculi after laparoscopic prostate cancer radical resection

作　　者：姚史武[1] 陈南辉[1] 刘思平[1] 何强[1] 

机构地区：[1]梅州市人民医院,广东梅州514000

出　　处：《腹腔镜外科杂志》2016年第7期533-535,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨腹腔镜前列腺癌根治性切除术后新发膀胱结石的治疗方法。方法：4例确诊为前列腺癌的患者作为研究对象,均行腹腔镜前列腺癌根治性切除术,患者1采用气压弹道碎石,清除结石;患者2应用钬激光碎石术,取出结石;患者3应用钬激光碎石并清除碎石,同时取出钛夹、结扎锁;患者4用钬激光切掉膀胱颈部、后尿道的增生息肉,并取出结扎锁。结果：本组4例患者均通过尿道微创手术治疗,取得了较理想的效果,术后患者症状完全消失,随访5-24个月未再出现排尿障碍、尿流中断、排尿疼痛、血尿等症状,定期复查泌尿系统未发现异常。结论：熟练的手术操作、良好的吻合技术、缝合对位不变形、缝线不宜过紧、尽量采用短时间内吸收的缝线及缝合口禁止使用结扎锁、钛夹利于避免腹腔镜前列腺癌根治性切除术后新发膀胱结石。Objective：To discuss the treatment method of bladder new stones after laparoscopic radical prostatectomy （LRP）. Methods：In this paper,4 patients diagnosed as prostate cancer were selected as the study objects, and underwent LRP. For the first patient pneumatic ballistic lithotripsy was used to remove calculi. The second patient underwent holmium laser lithotripsy. The third patient received holmium laser lithotripsy to remove calculi, at the same time, the titanium clip and the Hem-o-lok were removed. Holmium laser was used in the fourth patient to remove polype hyperplsique of bladder neck and posterior urethra, the Hem-o-lok was removed. Results：Four patients successfully underwent transurethral mini-invasive surgery with ideal results. After surgery symptoms of patients completely disappeared. The patients were followed up for 5-24 months without any symptoms such as urination disorder, interruption of urinary stream, painful urination, hematuria or other symptoms, and there were no abnormalities in a regular review of the urinary system. Conclusions ：The following measures are beneficial to avoid the new calculus of the bladder after LRP, such as skilled operation, good anastomosis technique, no deformation of suture, not too tight suture, trying to use suture which could be absorbed in a short period, Hem-o-lok and titanium clip are forbidden to use.

关 键 词：前列腺肿瘤 根治性切除术 腹腔镜检查 膀胱结石 

分 类 号：R737.25[医药卫生—肿瘤]