腹腔镜单纯尿道前壁加强法与尿道前后壁加强法(Sandwich法)改善前列腺癌根治术后早期尿控的对比分析

doi:10.3969/j.issn.1006-7795.2020.04.008

首都医科大学学报 ›› 2020, Vol. 41 ›› Issue (4): 542-546.doi: 10.3969/j.issn.1006-7795.2020.04.008

• 泌尿系统肿瘤基础与临床 • 上一篇下一篇

腹腔镜单纯尿道前壁加强法与尿道前后壁加强法(Sandwich法)改善前列腺癌根治术后早期尿控的对比分析

樊笑琪¹, 刘志斌², 王明帅¹, 瓦斯里江·瓦哈甫¹, 宋黎明¹, 邢念增³, 牛亦农¹

1. 首都医科大学泌尿外科研究所首都医科大学附属北京朝阳医院泌尿外科, 北京 100020;
2. 无锡市第九人民医院泌尿外科, 江苏无锡 214100;
3. 国家癌症中心国家肿瘤临床医学研究中心中国医学科学院北京协和医学院肿瘤医院, 北京 100021

收稿日期:2020-04-27 出版日期:2020-08-21 发布日期:2020-07-22
通讯作者: 牛亦农 E-mail:18601020160@163.com
基金资助:
国家自然科学基金（81770754），北京市自然科学基金（7172081）。

Comparative analysis of the improvement of early urinary control after radical prostatectomy by laparoscopic anterior urethral wall reconstruction and "Sandwich" reconstruction

Fan Xiaoqi¹, Liu Zhibin², Wang Mingshuai¹, Wasilijiang·Wahafu¹, Song Liming¹, Xing Nianzeng³, Niu Yinong¹

1. Institute of Urology, Capital Medical University;Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China;
2. Department of Urology, Ninth People's Hospital, Wuxi 214100, Jiangsu Province, China;
3. National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China

Received:2020-04-27 Online:2020-08-21 Published:2020-07-22
Supported by:
This study was supported by National Natural Science Foundation of China (81770754), Natural Science Foundation of Beijing (7172081).

摘要/Abstract

摘要： 目的探讨腹腔镜单纯尿道前壁悬吊加强法和尿道前后壁加强法对前列腺癌根治术后早期尿控的疗效。方法纳入自2014年2月至2019年12月，首都医科大学附属北京朝阳医院泌尿外科收治的99例前列腺癌患者，其中56例采用尿道前后壁加强法治疗，43例采用单纯尿道前壁悬吊加强法治疗，比较两组患者的年龄、体质量指数、前列腺体积、术前前列腺特异性抗原（prostate specific antigen，PSA），临床分期、手术时间、病理分期、Gleason评分、淋巴结阳性率、术后切缘阳性率及通过电话随访拔除尿管后第2、4、12、24、52周时的尿控恢复情况。结果两组患者的年龄、体质量指数、前列腺体积、PSA、临床分期、手术时间、病理分期、Gleason评分、淋巴结阳性率、术后切缘阳性率差异均无统计学意义（P>0.05），拔除尿管后第12周可见单纯尿道前壁悬吊加强法的治疗效果优于尿道前后壁加强法，但各指标差异仍无统计学意义（P=0.058）。结论腹腔镜前列腺癌根治术中采用前壁加强缝合悬吊法安全易行，与前后壁双重加强的方法相比，疗效接近。

关键词: 腹腔镜, 前列腺癌根治术, 尿失禁, 尿道前壁悬吊加强法

Abstract: Objective To investigate the effect of laparoscopic anterior urethral wall reconstruction and "Sandwich" reconstruction on early urinary control after radical prostatectomy. Methods A total of 99 patients with prostate cancer were enrolled from February 2014 to December 2019. Totally 56 patients were treated with "Sandwich" reconstruction, and 43 patients were treated with laparoscopic anterior urethral wall reconstruction. It was compared between the two groups with the age, body mass index, prostate volume, preoperative prostate specific antigen (PSA), clinical stage, operation time, pathological stage, Gleason score, lymph node positive rate, postoperative incisal margin positive rate and peripheral urinary control recovery. Results There was no significant difference in age, body mass index, prostate volume, PSA, clinical stage, operation time, pathological stage, Gleason score, lymph node positive rate, and postoperative incisors positive rate (P>0.05). At the 12th week after pulling out the urethral catheter, it was observed that the laparoscopic anterior urethral wall reconstruction was superior to the "Sandwich" reconstruction, but without statistically significance (P=0.058). Conclusion It is safe and easy to use the anterior urethral wall reconstruction in laparoscopic radical prostatectomy, which is superior to the"Sandwich" reconstruction.

Key words: laparoscopic, laparoscopic radical prostatectomy, incontinence, anterior urethral wall reconstruction

中图分类号:

R737.25

樊笑琪, 刘志斌, 王明帅, 瓦斯里江·瓦哈甫, 宋黎明, 邢念增, 牛亦农. 腹腔镜单纯尿道前壁加强法与尿道前后壁加强法(Sandwich法)改善前列腺癌根治术后早期尿控的对比分析[J]. 首都医科大学学报, 2020, 41(4): 542-546.

Fan Xiaoqi, Liu Zhibin, Wang Mingshuai, Wasilijiang·Wahafu, Song Liming, Xing Nianzeng, Niu Yinong. Comparative analysis of the improvement of early urinary control after radical prostatectomy by laparoscopic anterior urethral wall reconstruction and "Sandwich" reconstruction[J]. Journal of Capital Medical University, 2020, 41(4): 542-546.

参考文献 20

[1]	Shao Q, Ouyang J, Fan Y, et al. Prostate cancer in the senior men from rural areas in east district of China:Contemporary management and 5-year outcomes at multi-institutional collaboration[J]. Cancer Lett, 2012, 315(2):170-177.
[2]	Schuessler W W, Schulam P G, Clayman R V, et al. Laparoscopic radical prostatectomy:initial short-term experience[J]. Urology, 1997, 50(6):854-857.
[3]	崔昊昱,刘志宇,王梁,等.腹腔镜腹膜外前列腺癌根治术临床疗效分析[J].中国医科大学学报,2017,46(1):28-32.
[4]	Zargar-Shoshtari K, Murphy D G, Zargar H. Re:Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy:early outcomes from a Randomised Controlled Phase 3 Study[J]. Eur Urol, 2016, 71(1):141-142.
[5]	Michl U, Tennstedt P, Feldmeier L, et al. Nerve-sparing 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.
[6]	Lombraña M, Izquierdo L, Gómez A, et al. Impact of a nurse-run clinic on prevalence of urinary incontinence and everyday life in men undergoing radical prostatectomy[J]. J Wound Ostomy Continence Nurs, 2013, 40(3):309-312.
[7]	云燕.快速康复外科护理在腹腔镜下膀胱癌根治术围手术期中的应用效果[J].中华肿瘤防治杂志,2019,26(S1):234-235.
[8]	张立国,张金存,王磊,等.腹腔镜下挽救性根治性前列腺切除术对前列腺癌放疗后复发患者的临床疗效分析[J].中国煤炭工业医学杂志,2017,20(10):1196-1198.
[9]	Xu A J,Taksler G B, Elton L, et al. Long-term continence outcomes in men undergoing radical prostatectomy:a prospective 15-year longitudinal study[J]. J Urol, 2018,200(3):626-632.
[10]	Simonin O,Savoie P H, Serment G, et al. Urinary incontinence following open prostatectomy or laparoscopy for local prostate cancer. A review of relevant literature[J]. Prog Urol, 2010, 20(4):239-250.
[11]	Tienza A,Akin Y,Rassweiler J,et al. A match-pairanalysis of continence in intermediate and high-risk prostatecancer patients after robot-assisted radical prostatectomy:the roleof urine loss ratio and predictive analysis[J]. Prostate Int,2018,6(3):94-98.
[12]	Hoshi A, Usui Y, Shimizu Y, et al. Dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy[J]. Int J Urol, 2013, 20(5):493-500.
[13]	Suardi N,Moschini M, Gallina A, et al. Nerve-sparing approach during radical prostatectomy is strongly associated with the rate of postoperative urinary continence recovery[J]. BJU Int, 2013,111(5):717-722.
[14]	Akitake N, Shiota M, Obata H, et al.Neoadjuvantandrogen-deprivation therapy with radical prostatectomy forprostate cancer in association with age and serum testosterone[J]. Prostate Int,2018,6(3):104-109.
[15]	蔡海, 杨鹏, 许宁,等. 腹腔镜根治性前列腺切除术后尿控恢复影响因素分析[J]. 临床泌尿外科杂志, 2016, 31(10):903-906.
[16]	Hamada A,Razdan S, Etafy M H, et al. Early return of continence in patients undergoing robot-assisted laparoscopic prostatectomy using modified maximal urethral length preservation technique[J]. J Endourol, 2014, 28(8):930-938.
[17]	Haga N, Ogawa S, Yabe M, et al. Factors contributing to early recovery of urinary continence analyzed by pre- and postoperative pelvic anatomical features at robot-assisted laparoscopic radical prostatectomy[J]. J Endourol, 2015, 29(6):683-690.
[18]	刘志斌,靳松,张军晖,等.腹腔镜Sandwich法尿道及周围组织重建改善高风险组前列腺癌根治术后早期尿控的研究[J].首都医科大学学报,2016,37(3):313-317.
[19]	Wu M L Y, Wang C S, Xiao Q, et al. The therapeutic effect of pelvic floor muscle exercise on urinary incontinence after radical prostatectomy:a meta-analysis[J]. 亚洲男性学杂志(英文版), 2019, 21(2):170-176.
[20]	Westney O L, Scott S, Wood C, et al. Suburethral sling at the time of radical prostatectomy in patients at high risk of postoperative incontinence[J]. BJU Int, 2006, 98(2):308-313.

腹腔镜单纯尿道前壁加强法与尿道前后壁加强法(Sandwich法)改善前列腺癌根治术后早期尿控的对比分析

Comparative analysis of the improvement of early urinary control after radical prostatectomy by laparoscopic anterior urethral wall reconstruction and "Sandwich" reconstruction

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 20

相关文章 15

编辑推荐

Metrics

本文评价

[1]	魏后忆, 孙剑, 蒋一航, 关星, 王伟, 宋黎明, 牛亦农. 腹腔镜Boari膀胱壁瓣法输尿管膀胱再植术治疗中下段输尿管尿路上皮癌的临床效果[J]. 首都医科大学学报, 2020, 41(4): 547-551.
[2]	刘赛, 瓦斯里江·瓦哈甫, 牛亦农, 高建东, 崔丽艳, 宋黎明, 平浩, 杨飞亚, 王明帅, 邢念增. 加速康复外科在腹腔镜泌尿外科上尿路手术中的应用效果分析[J]. 首都医科大学学报, 2019, 40(1): 78-83.
[3]	杨硕, 刘雨辰, 王明刚, 申英末, 朱熠林, 曹金鑫, 邹振玉. 钛涂层复合补片与普通聚丙烯补片在腹腔镜腹股沟疝修补术中效果的前瞻性随机对照研究[J]. 首都医科大学学报, 2018, 39(2): 299-303.
[4]	计嘉军, 高峡, 付建柱, 栗光明, 伍冀湘. 免气腹腹腔镜胆道探查术对患者凝血功能的影响[J]. 首都医科大学学报, 2017, 38(6): 816-820.
[5]	王帆, 靳翠红, 赵凤林, 申英末, 陈杰. 自固定补片与钉合固定补片在巨大腹股沟疝行腹腔镜经腹腹膜前疝修补术中的对比研究[J]. 首都医科大学学报, 2017, 38(6): 911-914.
[6]	孙志鹏, 朱昱冰, 阿民布和, 樊庆, 李天雄, 张能维. 腹腔镜保脾胰体尾整块切除手术治疗胰腺癌的技术细节及预后[J]. 首都医科大学学报, 2017, 38(5): 733-739.
[7]	王宏, 薛紫怡, 李梦梦, 刘军, 张震宇. 产后压力性尿失禁病人生物反馈治疗后盆底肌表面电信号变化观察[J]. 首都医科大学学报, 2017, 38(2): 320-324.
[8]	梁阔, 刘东斌, 刘家峰, 徐大华, 王悦华, 李非. 腹腔镜胆总管探查一期缝合在老年胆总管结石病人中的应用[J]. 首都医科大学学报, 2017, 38(1): 78-81.
[9]	李晶华, 黄文燕, 张瑞, 马雪莲, 史从宁, 李文君, 冯力民. Ⅱ型子宫黏膜下肌瘤术前超声评估MFM的临床意义[J]. 首都医科大学学报, 2016, 37(4): 523-528.
[10]	刘志斌, 靳松, 张军晖, 王建文, 田溪泉, 田龙, 牛亦农, 邢念增. 腹腔镜Sandwich法尿道及周围组织重建改善高风险组前列腺癌根治术后早期尿控的研究[J]. 首都医科大学学报, 2016, 37(3): 313-317.
[11]	靳松, 张天, 郑颖洁, 宋黎明, 平浩, 瓦斯里江·瓦哈甫, 牛亦农, 邢念增. 高危组前列腺癌根治术后雄激素剥夺治疗联合早期放射治疗对局部控制及近期生存率的影响[J]. 首都医科大学学报, 2016, 37(3): 318-322.
[12]	李俊, 郭伟, 张军, 张忠涛. 转化医学与中国微创外科的发展[J]. 首都医科大学学报, 2015, 36(5): 800-804.
[13]	邱枫, 王今. 腹腔镜与开腹直肠癌手术近期疗效对比[J]. 首都医科大学学报, 2013, 34(5): 689-692.
[14]	宋黎明, 邢念增, 牛亦农, 张军晖, 田溪泉, 王建文. 后腹腔镜手术Ⅰ期治疗双侧肾癌2例并文献复习[J]. 首都医科大学学报, 2013, 34(3): 372-375.
[15]	金讯波, 张慧. 腹腔镜肾部分切除术中肾血管处理方法的研究进展[J]. 首都医科大学学报, 2013, 34(3): 376-379.