腹腔镜根治性前列腺切除术中背侧血管复合体的非结扎方法及耻骨前列腺韧带和盆腔内筋膜的保存:对尿失禁的影响。

IF 1 Q4 UROLOGY & NEPHROLOGY
José Gaona, Margarita M Zuluaga, Daniel H Flórez, Francia M Muñoz, Raul Rueda, Jairo Ortiz, Daniel E Sánchez, Cesar Gonzalez, Fabio Gonzalez, Angélica M Rueda, Sebastian Ortiz
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引用次数: 0

摘要

目的:评价在腹腔镜根治性前列腺切除术中,不结扎背侧血管复群、保留耻骨前列腺韧带和盆腔内筋膜的保留技术对1年随访期间尿失禁率的影响。材料和方法:前瞻性地收集了30例采用保存技术的患者的资料,并与60例采用传统非保存技术的患者的资料进行了比较。一个外科医生完成了所有的手术。结果:人口学特征和术前特征相似。两组患者平均年龄均为59岁。所有患者均为cT1c或cT2期。保存术组手术时间明显低于保存术组(229.6分钟vs 262.7分钟,P < 0.001)。两组在术中出血量、出院血红蛋白水平、输血率、住院时间、血红蛋白水平下降等方面差异无统计学意义。保存技术组尿失禁恢复的概率显著高于传统技术组(风险比= 0.50,95% CI = 0.31 ~ 0.81)。保存技术组与传统技术组在1、3、6、12个月的尿失禁率(0片/天)分别为53.3%对30% (P = 0.031)、90%对45% (P < 0.001)、90%对63.3% (P = 0.008)、96.6%对78.3% (P = 0.024)。两组之间在效力和肿瘤预后方面没有显著差异。结论:与传统的不结扎技术相比,不结扎背侧血管复合体并保留耻骨前列腺韧带和盆腔内筋膜可改善尿失禁,对出血和肿瘤预后无影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Dorsal Vascular Complex Nonligation Method and Preservation of Puboprostatic Ligaments and Endopelvic Fascia During Laparoscopic Radical Prostatectomy: Effect on Continence.

Dorsal Vascular Complex Nonligation Method and Preservation of Puboprostatic Ligaments and Endopelvic Fascia During Laparoscopic Radical Prostatectomy: Effect on Continence.

Dorsal Vascular Complex Nonligation Method and Preservation of Puboprostatic Ligaments and Endopelvic Fascia During Laparoscopic Radical Prostatectomy: Effect on Continence.

Dorsal Vascular Complex Nonligation Method and Preservation of Puboprostatic Ligaments and Endopelvic Fascia During Laparoscopic Radical Prostatectomy: Effect on Continence.

Objective: To evaluate the impact on continence rate during 1-year follow-up of a preservation technique that included nonligation of the dorsal vascular complex and sparing of the puboprostatic ligaments and the endopelvic fascia during laparoscopic radical prostatectomy.

Material and methods: Information from 30 patients who underwent the preservation technique was prospectively collected and compared with data from 60 patients who underwent the nonpreservation traditional technique. A single surgeon performed all procedures.

Results: Demographic and preoperative characteristics were similar. The mean patient age was 59 years in both groups. All patients were stage cT1c or cT2. Operative time was significantly lower in the preservation technique group (229.6 vs. 262.7 minutes, P < .001). There were no significant differences in intraoperative bleeding, discharge hemoglobin level, blood transfusion rate, length of hospitalization, and drop in the hemoglobin level. The probability of continence recovery was significantly higher in the preservation technique group than in the traditional technique group (hazard ratio = 0.50, 95% CI = 0.31-0.81). The continence rate (0 pads/day) for the preservation technique group versus the traditional technique group at 1, 3, 6, and 12 months was, respectively, 53.3% versus 30% (P = .031), 90% versus 45% (P < .001), 90% versus 63.3% (P = .008), and 96.6% versus 78.3% (P = .024). There were no significant differences between the groups regarding potency and oncologic outcomes.

Conclusion: Nonligation of the dorsal vascular complex and preservation of the puboprostatic ligaments and the endopelvic fascia improved urinary continence compared with the traditional nonpreservation technique, with no impact in terms of bleeding and oncologic outcomes.

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来源期刊
Turkish journal of urology
Turkish journal of urology Medicine-Urology
CiteScore
2.10
自引率
0.00%
发文量
53
期刊介绍: The aim of the Turkish Journal of Urology is to contribute to the literature by publishing scientifically high-quality research articles as well as reviews, editorials, letters to the editor and case reports. The journal’s target audience includes, urology specialists, medical specialty fellows and other specialists and practitioners who are interested in the field of urology.
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