直视下柱状电极内切开治疗21例前列腺癌根治术后吻合口狭窄的疗效  

Clinical efficacy of direct visual internal urethrotomy with cylindrical electrode in the treatment of 21 cases of anastomotic stenosis after radical prostatectomy

作　　者：王建 侯建全[2] 祝黎洁 糜远源 邵红宝 汪骏 吴升 WANG Jian;HOU Jian-quan;ZHU Li-jie;MI Yuan-yuan;SHAO Hong-bao;WANG Jun;WU Sheng(Department of Urology,The Affiliated Hospital of Jiangnan University,Wuxi 314000;Department of Urology,The First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]江南大学附属医院泌尿外科,江苏无锡231400 [2]苏州大学附属第一医院泌尿外科,江苏苏州215006

出　　处：《现代泌尿外科杂志》2020年第11期1008-1010,共3页Journal of Modern Urology

基　　金：国家自然青年科学基金(No.81802576)。

摘　　要：目的探讨直视下柱状电极内切开治疗前列腺癌根治术后膀胱尿道吻合口狭窄的临床效果。方法回顾性分析2012年3月至2019年6月江南大学附属医院泌尿外科利用等离子柱状电极治疗前列腺癌根治术(RP)后膀胱尿道吻合口狭窄的21例临床资料,比较手术前后最大尿流率、生活质量评分、膀胱残余尿的变化情况。结果本组21例患者手术均成功,其中2例膀胱软镜辅助完成。手术时间(32.0±6.7)(15~70)min,术后3~4周拔除导尿管后排尿通畅,无明显尿失禁。术后3月及12月最大尿流率较术前增加[(19.29±0.94)、(18.95±0.79)mL/s vs.(4.13±0.61)mL/s,P<0.0001];生活质量改善,其评分较术前降低[(2.10±0.54)、(2.00±0.45)分vs.(4.14±0.57)分,P<0.0001];膀胱残余尿降低[(27.86±5.76)、(25.95±5.15)mL vs.(251.14±20.80)mL,P<0.0001]。结论通过柱状电极治疗RP术后膀胱尿道吻合口狭窄疗效确切、安全可行,可作为一种可选择的手术方式,但需进一步随访该术式的更远期疗效。Objective To explore the clinical efficacy of direct visual internal urethrotomy with cylindrical electrode in the treatment of anastomosis stenosis after radical prostatectomy(RP).Methods A retrospective analysis was conducted in 21 patients with bladder urethral anastomotic stricture after RP using cylindrical electrodes during March 2012 and June 2019.The changes of maximum flow rate(Q max),quality of life(QoL)and residual urine volume(RUV)were compared before and after operation.Results All operations were successful,and 2 operations were assisted with flexible cystoscopy.The operation time was(32.0±6.7)(15-70)min.The catheter was removed 3-4 weeks after operation,and the urination was smooth with no obvious incontinence.The Q max rose from(4.13±0.61)mL/s before operation to(19.29±0.94)mL/s 3 months and(18.95±0.79)mL/s 12 months after operation(P<0.0001).QoL dropped from(4.14±0.57)before operation to(2.10±0.54)3 months and to(2.00±0.45)12 months after operation(P<0.0001).RUV decreased from(251.14±20.80)mL before operation to(27.86±5.76)mL 3 months and(25.95±5.15)mL 12 months after operation(P<0.0001).Conclusion Cylindrical electrode is safe and effective in the treatment of anastomosis stenosis after RP,but further follow-up is needed to observe the long-term efficacy.

关 键 词：前列腺癌根治术 尿道狭窄 柱状电极 尿道闭锁 吻合口狭窄 

分 类 号：R699.6[医药卫生—泌尿科学]