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目的:比较腹腔镜前列腺癌根治术中两种膀胱尿道吻合方法的患者临床资料,探讨单针体外牵拉缝合方法的效果。方法:回顾性分析95例接受经腹膜外腹腔镜前列腺癌根治术患者的临床资料。根据膀胱尿道吻合方法分为两组;双针连续缝合法组(A组,n=52)和单针体外牵拉缝合法组(B组,n=43)。分别比较两组手术时间、膀胱尿道吻合时间;引流管留置时间、导尿管留置时间、并发症以及手术切缘等指标。结果:与A组相比,B组有较短的手术时间(A组179.9min,B组142.8min,P<0.05)、膀胱尿道缝合时间(A组22.0min,B组12.9min,P<0.05);和较低的吻合口漏尿发生率(A组15.4%,B组2.3%,P<0.05)。但在术后尿道狭窄发生率、引流管留置时间、导尿管留置时间以及手术切缘阳性率等方面两组并无明显差异。结论:腹腔镜前列腺癌根治术中采用单针体外牵引缝合法可以缩短膀胱尿道吻合时间以及总手术时间,同时可以减少吻合口漏尿发生率。
Objective: To compare the clinical data of two methods of urinary bladder anastomosis in laparoscopic radical prostatectomy and explore the effect of single-needle external suture method. Methods: The clinical data of 95 patients who underwent radical retroperitoneal laparoscopic radical prostatectomy were retrospectively analyzed. According to the method of anastomosis of the bladder and urethra, the rats were divided into two groups; the two-needle continuous suture group (group A, n = 52) and the single-needle external suture group (group B, n = 43). The operative time, urinary bladder anastomosis time, drainage catheter indwelling time, urinary catheter indwelling time, complications and operative margin were compared. Results: Compared with group A, group B had shorter operative time (group A 179.9min, group B 142.8min, P <0.05), and bladder and urethra suture time (group A 22.0min, group B 12.9min, P 0.05 ); And lower incidence of anastomotic leakage (15.4% in group A, 2.3% in group B, P <0.05). However, there was no significant difference between the two groups in the incidence of postoperative urethral stricture, drainage tube indwelling time, urinary catheter indwelling time, and surgical margin positive rate. Conclusion: Single-needle external suture laparoscopic surgery in laparoscopic radical prostatectomy can shorten the time of urinary bladder anastomosis and the total operation time, and can reduce the incidence of anastomotic leakage.