腹腔镜下根治性前列腺切除术后不同引流方式的疗效分析  

Normal-versus negative-pressure drainage after laparoscopic radical prostatectomy in the treatment of prostate cancer

作　　者：陈家财 林山 赵力[1] 朱显忠 唐朝朋 李金雨[1] CHEN Jia-cai;LIN Shan;ZHAO Li;ZHU Xian-zhong;TANG Chao-peng;LI Jin-yu(Department of Urology,The 909th Hospital/Dongnan Hospital of Xiamen University,Zhangzhou,Fujian 363000,China;Department of Urology,General Hospital of Eastern Theater Command,Nanjing,Jiangsu 210002,China)

机构地区：[1]解放军第九〇九医院/厦门大学附属东南医院泌尿外科,福建漳州363000 [2]东部战区总医院泌尿外科,江苏南京210002

出　　处：《中华男科学杂志》2024年第12期1086-1090,共5页National Journal of Andrology

基　　金：解放军第九〇九医院院内青年苗圃基金(22QN003)。

摘　　要：目的:比较腹腔镜下根治性前列腺切除术后两种不同引流方式的引流效果。方法:回顾性分析2019年10月至2022年10行腹腔镜下根治性前列腺切除术中放置盆腔引流管的87例患者的临床与随访资料,根据术中放置引流的不同类型分为常压引流组(46例)和负压引流组(41例)。两组术中均留置1根F12硅胶引流管,常压引流组外接抗返流引流袋,负压引流组外接200 ml负压球。两组引流管均在引流量≤30 ml/d时拔除。对比两组手术时间、术中失血量、术后第1天引流量、术后总引流量、留置引流管时间、切口愈合时间、引流管护理耗时、拔除尿管时间及术后并发症发生率。结果:两组手术时间、术中失血量、切口愈合时间、术后并发症发生率均无统计学意义(P>0.05)。常压引流组术后第1天引流量、术后总引流量显著少于负压引流组,留置引流管时间、引流管护理耗时显著短于负压引流组,差异均有统计学意义(P<0.05)。结论:腹腔镜下根治性前列腺切除术后常压引流能明显减少术后引流量、缩短引流管留置时间,减少引流管护理工作耗时,是一种安全有效的引流方式。Objective:To compare the effects of normal-pressure drainage(norPD)and negative-pressure drainage(negPD)after laparoscopic radical prostatectomy(LRP)in the treatment of PCa.Methods:We retrospectively analyzed the clinical and follow-up data on 87 cases of PCa treated by LRP from October 2019 to October 2022,46 receiving norPD and the other 41 negPD postoperatively.We indwelt an F20 pelvic drainage tube for each of the patients,which were connected to an anti-reflux drainage bag for those in the norPD group and a 200 ml negative pressure ball for those in the negPD group,and removed the tubes at the drainage volume≤30 ml/d.We compared the operation time,intraoperative blood loss,drainage volume on the first day after surgery,total postoperative drainage volume,drainage tube-indwelling duration,drainage tube-related nursing time,urinary catheter removal time,wound healing time,and incidence of postoperative complications between the two groups of patients.Results:No statistically significant differences were observed between the two groups in terms of operation time,intraoperative blood loss,wound healing time,and postoperative complications(P>0.05).The drainage volume on the first postoperative day and the total postoperative drainage volume were significantly lower,and the drainage tube-indwelling duration and drainage tube-related nursing time markedly shorter in the norPD than in the negPD group(all P<0.05).Conclusion:Normal-pressure drainage is a safe and effective drainage method after laparoscopic radical prostatectomy,which can significantly reduce the postoperative drainage volume,drainage tube-indwelling duration and drainage tube-related nursing time.

关 键 词：前列腺癌 腹腔镜下根治性前列腺切除术 常压引流 负压引流 

分 类 号：R737.25[医药卫生—肿瘤]