| 摘要: |
| 目的 介绍机器人辅助腹腔镜根治性前列腺切除术（RARP）中三步法解剖性保留膀胱颈技术及初步体会。方法 回顾性分析2017年12月至2018年12月我院收治的RARP中运用三步法解剖性保留膀胱颈技术的30例前列腺癌患者资料。三步法解剖性保留膀胱颈技术主要步骤：（1）确定膀胱颈前列腺连接部位置，分离表面脂肪组织，直至暴露尿道前壁；（2）从膀胱前列腺三角区的相对疏松组织层面向深面解剖，直至暴露精囊前层面，沿此层面分离暴露尿道侧壁；（3）进一步解剖暴露尿道后壁。观察并记录保留膀胱颈成功率、保留膀胱颈口分段时间、不良事件发生率。结果 30例患者均在RARP中运用了三步法解剖性保留膀胱颈技术，保留膀胱颈成功率为93.3%（28/30），2例患者因前列腺中叶不规则突向膀胱而未完整保留膀胱颈。术中保留膀胱颈分段时间为8~10 min，平均（9.2±0.8）min。30例患者术中均无不良事件发生。结论 在RARP中运用三步法解剖性保留膀胱颈技术成功率高，值得推广。 |
| 关键词: 前列腺肿瘤 根治性前列腺切除术 机器人手术 腹腔镜技术 解剖性保留膀胱颈 |
| DOI：10.16781/j.0258-879x.2020.07.0747 |
| 投稿时间：2019-08-07修订日期：2020-02-13 |
| 基金项目: |
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| Application of three-step anatomical bladder neck preservation in robot-assisted laparoscopic radical prostatectomy |
| YUAN Jie,WANG Ming-chao,YU Shi-cheng,ZHU Shi-bin,LI Gong-hui* |
(Department of Urology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang, China
*Corresponding author) |
| Abstract: |
| Objective To introduce our experience on three-step anatomical bladder neck preservation in robot-assisted laparoscopic radical prostatectomy (RARP). Methods A retrospective analysis was conducted on the clinical data of 30 patients with prostate tumors, who were admitted to our hospital and received three-step anatomical bladder neck preservation in RARP from Dec. 2017 to Dec. 2018. The procedures of three-step anatomical bladder neck preservation were as follows:(1) locate the bladder neck-prostate junction, separate the surface fatty tissue, and expose the anterior wall of urethra; (2) dissect from the loose tissue layer between the trigone of bladder and prostate to the deep layer, expose the anterior layer of seminal vesicle, then expose the lateral wall of urethra along this layer; (3) dissect and expose the posterior wall of urethra. The success rate of bladder neck preservation, the time of bladder neck preservation and the incidence of adverse events were observed and recorded. Results All the 30 patients received three-step anatomical bladder neck preservation in RARP. The success rate of anatomical bladder neck preservation was 93.3% (28/30). The bladder neck failed to be completely preserved in two patients because of the irregular protrusion of the middle lobe of prostate to the bladder. The time of bladder neck preservation was 8-10 min, with an average of (9.2±0.8) min. No adverse events occurred. Conclusion The three-step anatomical bladder neck preservation in RARP has a high success rate and is worth promoting. |
| Key words: prostatic neoplasms radical prostatectomy robotic surgical procedures laparoscopy anatomical bladder neck preservation |
