保留膀胱颈的腹腔镜根治性前列腺切除术治疗前列腺癌的效果观察  

Observation on the efficacy of laparoscopic radical prostatectomy with preservation of the bladder neck in the treatment of prostate cancer

作　　者：沈立平[1] 梁平[1] 金卫 SHEN Liping;LIANG Ping;JIN Wei(People's Hospital of Haiyan County,Zhejiang 314300,China)

机构地区：[1]浙江省海盐县人民医院,海盐314300

出　　处：《浙江创伤外科》2025年第4期609-611,614,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的探讨分析前列腺癌的腹腔镜根治性前列腺切除术(LRP)治疗中保留膀胱颈的可行性。方法回顾性分析2021年6月至2023年1月本院收治的前列腺癌患者72例,根据手术方式不同分2组,各36例,两组均接受LRP治疗,对照组未保留膀胱颈,观察组保留膀胱颈,对比分析两组手术情况。结果观察组手术时间、术中出血量、术后留置尿管时间与对照组相比差异无统计学意义(P>0.05);观察组术后1个月、3个月的尿控良好率高于对照组(P<0.05);观察组术后3个月的最大尿流率、最大尿道压、膀胱顺应性水平较对照组更高(P<0.05);观察组切缘阳性率、吻合口狭窄率与对照组相比差异无统计学意义(P>0.05)。结论前列腺癌治疗中采用保留膀胱颈的LRP有助于提高术后早期尿控良好率,促进尿动力改善,且不增加切缘阳性率,吻合口狭窄率低。Objective To explore and analyze the feasibility of preserving the bladder neck in laparoscopic radical prostatectomy(LRP)for the treatment of prostate cancer.Methods A retrospective analysis was conducted on 72 patients with prostate cancer admitted to our hospital from June 2021 to January 2023.According to different surgical methods,they were divided into two groups,with 36 cases in each group.Both groups received LRP treatment.The control group did not preserve the bladder neck,while the observation group preserved the bladder neck.The surgical situations of the two groups were compared and analyzed.Results There was no significant difference in the operation time,intraoperative blood loss,and postoperative indwelling urinary catheter time between the observation group and the control group(P>0.05).The good urinary control rate at 1 month and 3 months after surgery in the observation group was higher than that in the control group(P<0.05).The maximum urinary flow rate,maximum urethral pressure,and bladder compliance levels at 3 months after surgery in the observation group were higher than those in the control group(P<0.05).There was no significant difference in the positive surgical margin rate and anastomotic stricture rate between the observation group and the control group(P>0.05).Conclusion In the treatment of prostate cancer,LRP with preservation of the bladder neck is helpful to improve the good urinary control rate in the early postoperative period,promote the improvement of urodynamics,and does not increase the positive surgical margin rate,with a low anastomotic stricture rate.

关 键 词：保留膀胱颈 腹腔镜根治性前列腺切除术 前列腺癌 尿动力学 

分 类 号：R737.2[医药卫生—肿瘤]