免缝扎背深静脉复合体技术在30例筋膜内保留神经腹腔镜根治性前列腺切除术中的应用  

Application of ligation-free technique of deep vein complex in 30 cases of intrafascial nerve-sparing laparoscopic radical prostatectomy

作　　者：陈玉明 申余勇 周海 祁乐中 王小祥 CHEN Yu-ming;SHEN Yu-yong;ZHOU Hai;QI Le-zhong;WANG Xiao-xiang(Department of Clinical Medicine,Medical School of Yangzhou University,Yangzhou 225000;Department of Urology,Affiliated Hospital of Yangzhou University,Yangzhou 225000,China)

机构地区：[1]扬州大学医学院临床医学系,江苏扬州225000 [2]扬州大学附属医院泌尿外科,江苏扬州225000

出　　处：《现代泌尿外科杂志》2019年第7期560-562,566,共4页Journal of Modern Urology

摘　　要：目的探讨双侧筋膜内腹腔镜前列腺癌根治术(INLRP)中免缝扎背深静脉复合体(DVC)的手术技巧和临床疗效。方法回顾性分析我院2015年1月至2018年06月30例双侧筋膜内腹腔镜前列腺癌根治术的患者资料,术中免缝扎DVC,统计手术时间、术中出血量、围术期输血率、手术切缘阳性率、术后生化复发、术后尿失禁(拔除尿管后即刻、1个月、3个月、6个月)及术后6个月性功能等数据。结果30例患者均在腹腔镜下顺利完成手术。手术时间(123.57±53.63)min,术中出血量(225.00±300.77)mL,手术切缘阳性率3/30(10.0%),输血率2/30(6.67%)。平均留置尿管11(8~15)d。拔除导尿管后即刻、1个月、3个月、6个月尿垫使用≤1块/d的患者占比分别为13.33%、53.33%、83.33%、96.67%。25例术前有性生活的患者术后6个月能勃起完成性交17例(68.0%)。随访期间术后6个月出现2例生化复发(6.67%)。结论双侧筋膜内腹腔镜前列腺癌根治术中免缝扎DVC安全有效,有利于术后控尿功能及性功能的早期恢复。Objective To explore the techniques and clinical outcomes of ligation-free for deep vein complex (DVC) in bilateral intrafascial nerve-sparing laparoscopic radical prostatectomy (INLRP).Methods The clinical data of 30 patients who underwent INLRP during Jan.2015 and June 2018 were retrospectively analyzed.DVC was not ligated during the operation.The operation time,intraoperative blood loss,perioperative blood transfusion rate,positive surgical margin rate,biochemical recurrence and urinary incontinence were recorded (immediately after catheter removal,1 month,3 and 6 months postoperatively).Potency was recorded 6 months postoperatively.Results All operations were successful.The operation time,estimated blood loss,positive surgical margin rate and transfusion rate was (123.57±53.63) minutes,(225.00±300.77) mL,3/30 (10.0 %),and 2/30 (6.67 %),respectively.The average catheter indwelling time was 11 (range,8~15) d.Postoperative in continence immediately after Foley catheter removal,and 1 month,3 and 6 months after surgery was 13.33 %,53.33 %,83.33 % and 96.67 %,respectively.Of the 25 preoperatively sexually active patients,17(68.0 %) were able to erect adequately and perform sexual intercourse 6 months after operation.Biochemical relapse occurred in 2 cases (6.67 %) during the follow-up.Conclusion Ligation-free technique for DVC is safe and effective in bilateral intrafascial nerve-sparing laparoscopic radical prostatectomy,which is conducive to the early recovery of continence and sexual function.

关 键 词：前列腺癌 筋膜内腹腔镜 背深静脉复合体 

分 类 号：R737.25[医药卫生—肿瘤]