倒刺缝线在腹腔镜下前列腺癌根治术中的应用研究  

Application of Quill suture in laparoscopic radical prostatectomy

作　　者：沙建军[1] 潘家骅[1] 吴小荣[1] 迟辰斐 朱寅杰[1] 董柏君[1] 薄隽杰[1] 刘东明[1] 薛蔚[1] SHA Jianjun PAN Jiahua WU Xiaorong CHI Chenfei ZHU Yinjie DONG Baijun BO Juanjie LIU Dongming XUE Wei(Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China)

机构地区：[1]上海交通大学医学院附属仁济医院泌尿外科,上海200127

出　　处：《临床泌尿外科杂志》2017年第9期658-661,共4页Journal of Clinical Urology

摘　　要：目的:比较Quill倒刺缝线和普通缝线在腹腔镜前列腺癌根治术中处理膀胱颈-尿道吻合口的效果,评价Quill倒刺缝线在腹腔镜前列腺癌根治术中的安全性和有效性。方法:回顾性分析2014年1月~2016年12月期间由单一术者实施腹腔镜下前列腺癌根治术治疗的215例局限性前列腺癌患者资料,其中110例以Quill倒刺缝线连续缝合法(Quill缝线组)吻合膀胱颈与尿道,105例以普通缝线单针连续缝合法(普通缝线组)吻合膀胱颈与尿道。比较两组的吻合时间、术中出血量、导尿管留置时间、引流管留置时间、住院时间及尿漏等并发症的情况。结果:215例腹腔镜下前列腺癌根治术均获成功,无一例中转开放。Quill缝线组膀胱颈-尿道平均吻合时间为15.6(11~23)min,普通缝线组膀胱颈-尿道平均吻合时间为19(13~29)min,两组比较差异有统计学意义(P<0.05);两组术中出血量、留置导尿管及引流管时间、术后平均住院天数差异无统计学意义(P>0.05)。Quill缝线组术后尿漏患者1例,引流管时间留置2周后吸收痊愈。普通缝线组术后尿漏3例,均经保守治疗后痊愈,组间比较差异无统计学意义(P>0.05)。结论:Quill倒刺缝线在腹腔镜前列腺癌根治术中的应用安全、有效,简化了手术操作,降低手术难度,与传统的缝线相比,明显缩短了膀胱颈-尿道重建时间。Objective：To compare the efficiency between Quill suture and single needle running suture in the urethrovesical anastomosis（UVA）in laparoscopic radical prostatectomy（LRP）,and to evaluate the safety and effectiveness of continuous suturing by Quill suture in LRP.Method：A retrospective study was conducted on 215 patients with localized prostate cancer undergoing LRP from January 2014 to December 2016.The patients were divided into two groups：110 cases underwent UVA with Quill suture（Quill group）;105cases underwent UVA by means of single needle running suture（Ordinary group）.The time of UVA,estimated blood loss（EBL）,duration of drainage tube and Foley catheter,length of hospital stay（LOS）,postoperative complication such as urinary leakage were compared between the two groups.Result：All of 215 cases were finished successfully without conversion to open surgery.The mean time of UVA was（15.6±3.9）min in the Quill group,which was significantly shorter than that in the Ordinary group（19±4.5）min（P〈0.05）.EBL,duration of drainage tube and Foley catheter and LOS were similar between two groups.The postoperative urinary leakage was observed in one case in Quill group and three cases in Ordinary group without statistical difference（P〉0.05）.All of these patients were cured by conservative treatment.Conclusion：The use of Quill suture in LRP is safe and effective.This technique can simplify the operation,reduce the operation difficulty,meanwhile,significantly shorten the time of UVA compared with conventional suture.

关 键 词：前列腺肿瘤 腹腔镜 前列腺切除术 

分 类 号：R737.25[医药卫生—肿瘤]