中国的机器人外科学杂志 | ISSN 2096-7721 | CN 10-1650/R

机器人辅助单孔腹腔镜前列腺根治性切除术中保留膀胱颈技术对术后尿控的效果研究(附视频)

Effect of bladder neck preservation technique on postoperative urinary continence after single-port robot-assisted laparoscopic radical prostatectomy (with video)

作者:季倩莹,王俊,魏勇,庞名扬,张业韬 ,赵彤,董宇翔 ,朱清毅

Vol. 5 No. 1 Feb. 2024 DOI: 10.12180/j.issn.2096-7721.2024.01.002 发布日期:2024-03-06
关键词:机器人辅助手术;单孔腹腔镜手术;前列腺根治性切除术;术后尿控功能;膀胱颈保留技术

作者简介:

目的:为了评估保留膀胱颈技术应用在机器人辅助单孔腹腔镜前列腺根治性切除术中对于围手术期结果 及术后尿控的影响。方法:回顾性分析 2020 年 1 月—2020 年 12 月于南京中医药大学附属医院行机器人辅助单孔腹 腔镜前列腺根治性切除术的 69 例患者临床资料。其中 33 例为对照组(膀胱颈未完整保留),36 例为观察组(完整 保留膀胱颈),对患者的临床基本数据和围手术期结果进行比较。结果:比较两组患者的临床资料,差异无统计学 意义(P>0.05)。比较对照组与观察组的手术时间和出血量,差异无统计学意义(P>0.05);而观察组在术后引流管 放置时间和住院时间方面均更短,差异具有统计学意义(P<0.05)。术后尿控方面,观察组较对照组术后尿控功能恢 复快,差异具有统计学意义(P<0.05),且观察组术后 3、6、12 个月的尿控恢复率均较高。结论:完整保留膀胱颈 技术应用于机器人辅助单孔腹腔镜前列腺根治性切除术,有益于加快术后康复,帮助患者快速恢复术后尿控功能。

Objective: To assess the clinical effect of bladder neck preservation technique on perioperative outcomes and postoperative urine continence after robot-assisted laparoendoscopic single-site radical prostatecomy (R-LESS-RP). Methods: The clinical data of 69 patients who underwent R-LESS-RP in the Affiliated Hospital of Nanjing University of Chinese Medicine from January 2020 to December 2020 were analyzed retrospectively. Among them, 33 cases were divided into the control group (bladder neck was not completely preserved) and 36 cases into the observation group (complete preservation of the bladder neck). The basic clinical data and perioperative results of the two groups were compared. Results: There was no significant difference in clinical data between the two groups (P>0.05). There was no significant difference in operative time and blood loss between the control group and the observation group (P>0.05). The time of postoperative drainage tube placement and hospital stay in the observation group were shorter, and the difference was statistically significant (P<0.05). In terms of postoperative urinary continence, the urinary continence of the observation group recovered faster than that of the control group, and the difference was statistically significant (P<0.05). The recovery rate of urinary continence was higher in the observation group than that in the control group at 3, 6 and 12 months after surgery. Conclusion: The application of complete bladder neck preservation technique in R-LESS-RP is beneficial to accelerate postoperative rehabilitation and could help patients quickly recover from postoperative urinary continence.

稿件信息

收稿日期:2023-03-21  录用日期:2023-06-28

Received Date: 2023-03-21  Accepted Date: 2023-06-28

基金项目:江苏省卫生健康委科研项目(ZD2021028)

Foundation Item: Scientific Research Project of Jiangsu Provincial Health Commission(ZD2021028) 

通讯作者:朱清毅,Email:drzhuqingy@126.com 

Corresponding Author: ZHU Qingyi, Email: drzhuqingy@126.com 

引用格式:季倩莹,王俊,魏勇,等 . 机器人辅助单孔腹腔镜前列腺根治性切除术中保留膀胱颈技术对术后尿控的效果研究(附视频)[J]. 机器人外科学杂志(中英文),2024,5(1):7-12. 

Citation: JI Q Y, WANG J, WEI Y, et al. Effect of bladder neck preservation technique on postoperative urinary continence after single-port robot-assisted laparoscopic radical prostatectomy (with video) [J]. Chinese Journal of Robotic Surgery, 2024, 5(1): 7-12. 

注:季倩莹,王俊,魏勇为共同第一作者 

Co-first Author: JI Qianying, WANG Jun, WEI Yong

参考文献

[1] Siegel R L, Miller K D, Fuchs H E, et al. Cancer statistics, 2021[J]. CA Cancer J Clin, 2021, 71 (1): 7-33. 

[2] Wong M C, Goggins W B, Wang H H, et al. Global incidence and mortality for prostate cancer: analysis of temporal patterns and trends in 36 countries[J]. Eur Urol, 2016, 70 (5): 862-874. 

[3] Ficarra V, Novara G, Rosen R C, et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy[J]. Eur Urol, 2012. DOI: 10.1016/j.eururo.2012.05.045. 

[4] 朱清毅 , 林建中 , 魏勇 , 等 . 脱套式功能尿道保留 在前列腺癌根治性术中应用 [J]. 南京医科大学学 报 : 自然科学版 , 2022, 42(12): 3. 

[5] Vis A N, van der Poel H G, Ruiter A E C, et al. Posterior, anterior, and periurethral surgical reconstruction of urinary continence mechanisms in robot-assisted radical prostatectomy: a description and video compilation of commonly performed surgical techniques[J]. Eur Urol, 2019, 76 (6): 814-822. 

[6] Galfano A, Di Trapani D, Sozzi F, et al. Beyond the learning curve of the Retzius-sparing approach for robotassisted laparoscopic radical prostatectomy: oncologic and functional results of the first 200 patients with ≥ 1 year of follow-up[J]. Eur Urol, 2013. DOI: 10.1016/ j.eururo.

[7] Michl U, Tennstedt P, Feldmeier L, et al. Nervesparing surgery technique, not the preservation of the neurovascular bundles, leads to improved long-term continence rates after radical prostatectomy[J]. Eur Urol, 2016, 69 (4): 584-589. 

[8] Mungovan S F, Sandhu J S, Akin O, et al. Preoperative membranous urethral length measurement and continence recovery following radical prostatectomy: a systematic review and meta-analysis. Eur Urol, 2017, 71 (3): 368-378. 

[9] 邢念增 . 腹腔镜根治性前列腺切除术中“三明治” 尿道重建技术的理论基础与技术技巧 [J]. 山东大学 学报 ( 医学版 ), 2019, 57(1): 16-20. 

[10] Patel V R, Coelho R F, Palmer K J, et al. Periurethral suspension stitch during robot-assisted laparoscopic radical prostatectomy: description of the technique and continence outcomes[J]. Eur Urol, 2009, 56 (3): 472-478. 

[11] Chung J W, Kim S W, Kang H W , et al. Efficacy of modified radical prostatectomy technique for recovery of urinary incontinence in high-grade prostate cancer[J]. Minerva Urol Nefrol, 2020, 72 (5): 605-614. 

[12] Stolzenburg J U, Holze S, Arthanareeswaran V K, et al. Robotic-assisted versus laparoscopic radical prostatectomy: 12-month outcomes of the multicentre randomised controlled lap-01 trial[J]. Eur Urol Focus,2022, 8 (6): 1583-1590. 

[13] Sandhu J S, Breyer B, Comiter C, et al. Incontinence after prostate treatment: AUA/SUFU guideline[J]. J Urol, 2019, 202 (2): 369-378. 

[14] Dalela D, Jeong W, Prasad M A, et al. A pragmatic randomized controlled trial examining the impact of the retzius-sparing approach on early urinary continence recovery after robot-assisted radical prostatectomy[J]. Eur Urol, 2017, 72 (5): 677-685. 

[15] Porpiglia F, Morra I, Lucci Chiarissi M, et al. Randomised controlled trial comparing laparoscopic and robot-assisted radical prostatectomy[J]. Eur Urol, 2013, 63 (4): 606-614. 

[16] Wiatr T, Choragwicki D, Gronostaj K, et al. Long-term functional outcomes of vesicourethral anastomosis with bladder neck preservation and distal urethral length preservation after videolaparoscopic radical prostatectomy[J]. Wideochir Inne Tech Maloinwazyjne, 2022, 17(3), 540-547. 

[17] Nguyen L N, Head L, Witiuk K, et al. The risks and benefits of cavernous neurovascular bundle sparing during radical prostatectomy: a systematic review and meta-analysis[J]. J Urol, 2017, 198 (4): 760-769.

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