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中华腔镜外科杂志(电子版) ›› 2022, Vol. 15 ›› Issue (02): 106 -109. doi: 10.3877/cma.j.issn.1674-6899.2022.02.009

论著 上一篇    

经腹途径机器人辅助前列腺增生切除术初步经验
韩毅力1, 赵佳晖1, 罗勇1, 李明川1, 魏德超1, 姜永光1,()   
  1. 1. 100029 北京,首都医科大学附属北京安贞医院泌尿外科
  • 收稿日期:2021-12-31 出版日期:2022-04-30
  • 通信作者: 姜永光

Transperitoneal approach robotic-assisted simple prostatectomy for benign prostatic hyperplasia: initial experience

Yili Han1, Jiahui Zhao1, Yong Luo1, Mingchuan Li1, Dechao Wei1, Yongguang Jiang1,()   

  1. 1. Department of Urology, Beijing Anzhen Hospital, Capital Medicine University, Beijing 100029, China
  • Received:2021-12-31 Published:2022-04-30
  • Corresponding author: Yongguang Jiang
目的

探讨经腹途径机器人辅助前列腺增生切除术(robotic-assisted simple prostatectomy,RASP)治疗大体积良性前列腺增生的手术经验、临床安全性及可行性。

方法

回顾性分析2017年1月至2021年1月期间,首都医科大学附属北京安贞医院行RASP治疗的21例前列腺增生患者临床资料,对手术程序、术中和术后所存在的问题进行总结。

结果

21例患者均顺利完成手术,无中转开放手术;平均手术时间(135.7±23.2)min,平均术中出血量(168.4±21.5)ml,无输血,术后24 h内停止膀胱冲洗,拔除造口管时间为术后2 d,拔除引流管时间为术后3 d,平均拔除尿管时间(12.5±2.4)d。术后3个月复查残余尿量、最大尿流率和国际前列腺症状评分均有改善,差异有统计学意义(P<0.01)。

结论

RASP治疗大体积良性前列腺增生是一种安全、有效的微创方法,可能成为大体积良性前列腺增生的可选治疗手段。

Objective

To investigate the experience, safety and feasibility of robot assisted simple prostatectomy for large volume benign prostatic hyperplasia (BPH).

Methods

The clinical data of 21 patients who underwent robot assisted simple prostatectomy in our hospital from Jan. 2017 to Jan. 2021 were retrospectively analyzed, and the surgical procedures, intraoperative and postoperative problems were summarized.

Results

All cases were operated successfully without conversion to open surgery. The average operation time was (135.7±23.2) min. The average blood loss was (168.4±21.5) ml without blood transfusion in all cases. Bladder irrigation time was within 24 h after operation. The average suprapubic catheter time was 2 days. The average drain time was 3 days, and the mean catheter time was (12.5±2.4) days. Post-void residual, international prostate symptom score (IPSS) and maximum urine flow were improved significantly 3 months after operation (P<0.01).

Conclusions

Transperitoneal robot assisted simple prostatectomy is a safe and effective minimally invasive method for large volume benign prostatic hyperplasia, which may become an alternative treatment.

图1 经腹机器人辅助前列腺增生切除术注:A.悬吊膀胱切缘;B.悬吊膀胱内突出腺体;C.切开膀胱后唇;D.游离增生腺体;E.缝合前列腺窝切缘;F.缝合膀胱
表1 经腹途径机器人辅助前列腺增生切除术患者手术前后排尿症状比较(±s)
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