局限性前列腺癌行保留膀胱颈的腹腔镜根治性前列腺切除术对控尿的影响  

Impact of bladder neck preservation on continence in laparoscopic radical prostatectomy for localized prostate cancer

作　　者：何威[1] 邢思伟 徐丹枫[1] 黄欣[1] 汪成合[1] 戴军[1] 赵菊平[1] 方晨[1] 黄答 孙福康[1] HE Wei;XING Siwei;XU Danfeng;HUANG Xin;WANG Chenghe;DAI Jun;ZHAO Juping;FANG Chen;HUANG Da;SUN Fukang(Department of Urology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院泌尿外科,上海200025

出　　处：《临床泌尿外科杂志》2024年第7期567-570,共4页Journal of Clinical Urology

摘　　要：目的:探讨腹腔镜根治性前列腺切除术(laparoscopic radical prostatectomy,LRP)中,保留膀胱颈部对术后尿控的影响。方法:回顾性分析上海交通大学医学院附属瑞金医院泌尿外科于2018年1月—2022年12月行LRP的局限性前列腺癌患者160例,将保留膀胱颈组与未保留膀胱颈组的术后(1、3、6个月)尿控进行比较。结果:160例患者中72例保留膀胱颈,88例未保留膀胱颈。保留膀胱颈组和未保留膀胱颈组的手术时间、失血量、吻合口狭窄率差异均无统计学意义(P>0.05)。术后所有患者无膀胱颈切缘阳性。行筋膜内切除患者,保留膀胱颈组术后1、3个月控尿率高于未保留膀胱颈组(P<0.05),术后6个月,保留膀胱颈组和未保留膀胱颈组控尿率差异无统计学意义(P>0.05)。行筋膜外切除患者,术后1、3、6个月,保留膀胱颈组和未保留膀胱颈组控尿率差异无统计学意义(P>0.05)。结论:局限性前列腺癌行筋膜内切除,保留膀胱颈利于早期尿控恢复。对于行筋膜外LRP患者,没有必要刻意保留膀胱颈。Objective To discuss the effects of bladder neck preservation on continence after laparoscopic radical prostatectomy(LRP).Methods The continence rate between bladder neck preservation group and non-preservation group was compared by retrospectively analyzing 160 cases of LRP for localized prostate cancer.Results There were 72 cases in bladder neck preservation group,and 88 cases in non-preservation group.No statistical significance was identified in operating time(OT),estimated blood loss(EBL),or anastomotic stricture(P>0.05).No positive margin on bladder neck was noticed pathologically in each case.In intrafascial LRP,continence rate was better in bladder neck preservation group than non-preservation group after one month and three months,but roughly the same after six months.In extrafascial LRP,there was no statistical significance between bladder neck preservation group and non-preservation group regardless of time.Conclusion The early continence recovery after LRP benefits from bladder neck preservation,which makes sense only in cases of intrafascial LRP.

关 键 词：腹腔镜根治性前列腺切除 筋膜内 膀胱颈保留 尿控 

分 类 号：R737.25[医药卫生—肿瘤]