PPLs对RARP患者术后尿控恢复的影响  

Effect of preserving the puboprostatic ligament on urinary control recovery after radical laparoscopic resection of prostate cancer

作　　者：李涛[1] 孙欣[1] 殷锋彦[1] 罗晓辉[1] 索杰[1] 黄晓东[1] 王晨青 Li Tao;Sun Xin;Yin Fengyan;Luo Xiaohui;Suo Jie;Huang Xiaodong;Wang Chenqing(Department of Urology,Baoji Central Hospital,Baoji 721008,China)

机构地区：[1]宝鸡市中心医院泌尿外科,宝鸡721008

出　　处：《国际泌尿系统杂志》2024年第6期985-988,共4页International Journal of Urology and Nephrology

基　　金：陕西省卫生健康2021年度卫生健康科研项目(2021C002)。

摘　　要：目的探讨保留耻骨前列腺韧带(PPLs)对机器人辅助腹腔镜下前列腺癌根治性切除术(RARP)患者术后尿控恢复的影响。方法回顾性选择2022年1月至2024年1月在本院收治的96例前列腺癌(PCa)患者作为研究对象,根据不同术式将患者分为保留组(保留PPLs行RAPP,48例)与常规组(常规RARP,48例)。比较两组患者的围手术期指标(术中出血量、引流管留置、住院及手术时间)、国际尿失禁咨询问卷尿失禁简表(ICIQ-UISF)评分、并发症(尿瘘、直肠损伤、感染、下肢深静脉血栓)发生率。结果两组患者的引流管留置时间、术中出血量比较,差异均无统计学意义(均P>0.05);保留组的手术、住院时间短于常规组,差异均有统计学意义(均P<0.05);两组患者手术完成之后拔除尿管时的ICIQ-UISF评分比较,差异无统计学意义(P>0.05);两组患者手术完成之后拔除尿管3个月时的日常生活影响评分、漏尿量评分比较,差异均无统计学意义(均P>0.05);保留组手术完成之后拔除尿管3个月时的漏尿频率评分、总评分低于常规组,差异均有统计学意义(均P<0.05);保留组手术完成之后拔除尿管1年时的ICIQ-UISF评分低于常规组,差异有统计学意义(P<0.05);两组患者的尿瘘、直肠损伤、感染、下肢深静脉血栓发生率比较,差异均无统计学意义(均P>0.05)。结论PCa患者治疗中保留PPLs的RARP效果显著,可进一步促进患者术后尿控功能快速恢复,且并发症少。ObjectiveTo investigate the effect of preserving the puboprostatic ligament(PPLs)on urinary control recovery after robot-assisted laparoscopic radical resection of prostate cancer(RARP).MethodsFrom January 2022 to January 2024,96 patients with prostate cancer(PCa)admitted to hospital were retrospectively selected and divided into retention group(RAPP with PPLs reserved,48 cases)and routine group(RARP,48 cases)according to different operation methods.The perioperative indexes(intraoperative blood loss,drainage tube retention,hospitalization and operation time),ICIQ-UISF score,incidence of complications(urinary fistula,rectal injury,infection and deep venous thrombosis of lower limbs)were compared between the two groups.ResultsThere were no significant differences in drainage tube retention time and intraoperative blood loss between the two patients(all P>0.05).The operation time and hospital stay in the retention group were shorter than those in the conventional group,and the differences were statistically significant(all P<0.05).There was no significant difference in the ICIQ-UISF scores between the two groups(P>0.05).There were no significant differences in the degree of life impact and volume of urine leakage three months after catheter removal between the two groups(all P>0.05).However,at three months post-catheter removal,the retention group exhibited lower scores for urinary leakage frequency and total score compared to the conventional group,with statistical significance(all P<0.05).Furthermore,one year after catheter removal,the retention group had a significantly lower ICIQ-UISF score than the conventional group(P<0.05).There was no significant difference in the incidence of urinary fistula,rectal injury,infection,and lower extremity deep vein thrombosis between the two groups(all P>0.05).ConclusionsThe retention of PPLs in RARP for PCa patients exerts a significant impact,thereby further enhancing the prompt recovery of postoperative urinary control function while minimizing complications.

关 键 词：前列腺肿瘤 前列腺切除术 腹腔镜检查 耻骨前列腺韧带 尿失禁 

分 类 号：R737.25[医药卫生—肿瘤]