经膀胱路径机器人辅助腹腔镜根治性前列腺切除术13例报告  

Transvesical robot-assisted radical prostatectomy:a report of 13 cases preliminary experience in a single center

作　　者：毕航 付德来[1] 李建平[1] 唐骁爽[1] 陈海文[1] 雒启东[1] 陈琦[1] 南宁[1] 王莉[1] 种铁[1] 李钊伦[1] BI Hang;FU Delai;LI Jianping;TANG Xiaoshuang;CHEN Haiwen;LUO Qidong;CHEN Qi;NAN Ning;WANG Li;CHONG Tie;LI Zhaolun(Department of Urology,The Second Affiliated Hospital of Medical,Xi an Jiaotong University,Xi an 710004,China)

机构地区：[1]西安交通大学第二附属医院泌尿外科,陕西西安710004

出　　处：《现代泌尿外科杂志》2023年第5期413-416,420,共5页Journal of Modern Urology

摘　　要：目的分享经膀胱路径机器人辅助腹腔镜根治性前列腺切除术(TvRARP)的技术要点及体会。方法收集2021年11月-2022年5月于西安交通大学第二附属医院行TvRARP的13例患者的临床资料。评估该术式手术时间、术中估计出血量、术中输血量、术后拔除尿管时间、术后住院时间、术后即刻尿控率、术后国际勃起功能指数-5问卷(IIEF-5)评分及围手术期并发症等。结果13例患者手术时间为(142±39)min。术中估计出血量为(76±40)mL,无患者输血。术后中位IIEF-5评分16(12~22)分,术后中位住院时间3(2~5)d。术后中位拔除尿管时间7(5~14)d,其中12例(92.3%)患者拔除尿管后实现即刻尿控。无ClavienⅢ级及以上并发症发生,ClavienⅠ~Ⅱ级并发症4例(30.8%)。结论TvRARP有较高的即刻控尿率和较佳的性功能保护作用,无严重并发症发生,适合经严格筛选的早期局限性前列腺癌患者。Objective To share the technical key points and experience of transvesical robot-assisted radical prostatectomy(TvRARP).Methods The clinical data of 13 patients with prostate cancer(PCa)receiving TvRARP during Nov.2021 and May 2022 were collected.The operation time,estimated blood loss,blood transfusion rate,catheter removal time,postoperative length of hospital stay,immediate urinary continence rate,postoperative IIEF-5 score and perioperative complications were evaluated.Results The operation time was(142±39)min,estimated intraoperative blood loss was(76±40)mL,and no transfusion was needed.The median postoperative IIEF-5 score was 16(12-22),hospital stay 3(2-5)days,and catheter removal time 7(5-14)days.Of all 13 patients,12(92.3%)achieved immediate urinary continence at the removal of catheter.There were no postoperative complications of ClavienⅢand above.ClavienⅠ-Ⅱcomplications were observed in 4 patients(30.8%).Conclusion TvRARP is feasible and safe for selected patients with clinically localized PCa,which can ensure promising postoperative urinary continence and preserve erectile functional.

关 键 词：经膀胱路径 前列腺癌 机器人辅助腹腔镜根治性前列腺切除术 即刻控尿率 性功能 

分 类 号：R699[医药卫生—泌尿科学]