耻骨上经膀胱单孔机器人前列腺癌根治术的初步尝试  

Preliminary report of suprapubic transvesical single-port robot assisted radical prostatectomy for prostate cancer

作　　者：姜帅 许培榕 姚家喜 赵奇 夏雨 郭剑明 JIANG Shuai;XU Pei-rong;YAO Jia-xi;ZHAO Qi;XIA Yu;GUO Jian-ming(Department of Urology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院泌尿外科,上海200032

出　　处：《中国临床医学》2019年第2期215-217,共3页Chinese Journal of Clinical Medicine

基　　金：吴阶平医学基金会临床科研专项资助基金(No.320.6750.15226)~~

摘　　要：目的:总结耻骨上经膀胱单孔机器人辅助腹腔镜前列腺癌根治术的初步经验。方法:选择3例前列腺癌患者,完成单孔机器人辅助腹腔镜耻骨上经膀胱入路前列腺癌根治术。直视下建立并将单孔通道置入膀胱。手术过程包括沿前列腺边界环形切开膀胱颈,沿前列腺包膜分离并切除输精管、精囊,结扎前列腺侧韧带,不缝扎阴茎背深静脉复合体(DVC),离断前列腺尖部,切断尿道,行尿道膀胱颈吻合。结果:3例患者手术均由耻骨上经膀胱入路在单孔机器人辅助腹腔镜下完成。前列腺体积分别为16 mL、22 mL、43 mL。手术时间分别为90 min、120 min、150 min。术中出血量分别为50 mL、150 mL、200 mL。术中不留置膀胱造瘘管及伤口引流管,术后7～9 d拔除导尿管。拔管后患者完全控尿。结论:耻骨上经膀胱单孔机器人前列腺癌根治术对早期前列腺癌患者安全、有效,值得进一步推广。Objective:To summarize the preliminary experience suprapubic transvesical single-port robot assisted radical prostatectomy for prostate cancer.Methods:Three patients with prostate cancer were selected to undergo single-port robot assisted laparoscopic radical prostatectomy via an suprapubic transvesical approach.A single-port channel was established and was introduced percutaneously into the bladder under direct vision.The surgical procedure included incision of the bladder neck along the border of the prostate,separation and removal of the vas deferens,seminal vesicles,and prostate ligaments outside the prostate capsule.The dorsal vein complex(DVC)was not sewed.The prostate tip was cut off and the urethra was cut.The urethral bladder neck anastomosis was performed.Results:All 3 cases were performed with single-port robot assisted laparoscopic surgery via the suprapubic transvesical approach.The volume of the prostate was 16 mL,22 mL,and 43 mL,respectively,and the operation time was 90 min,120 min,and 150 min,respectively.The intraoperative blood loss was 50 mL,150 mL,and 200 mL,respectively.The wound drainage tube and bladder stoma were not placed and the catheters were removed 7-9 days after surgery.No patients developed urinary incontinence after removing the catheter.Conclusions:Single-port robot assisted laparoscopic radical prostatectomy via the suprapubic transvesical approach is safe and effective for early stage prostate cancer,and it is worthy of further promotion.

关 键 词：前列腺癌 单孔机器人 经膀胱 耻骨上 

分 类 号：R737.25[医药卫生—肿瘤]