Significance of MULP laparoscopic radical prostatectomy for the recovery of urinary continence as soon as possible
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摘要: 目的:研究最长尿道长度保存 (maximal urethral length preservation, MULP) 对腹腔镜前列腺癌根治术后尽快恢复尿控的临床意义。方法:回顾性分析我院2013年2月~2015年3月80例行腹腔镜前列腺癌根治术的临床资料, 随访至2016年3月。其中40例进行MULP腹腔镜前列腺癌根治术患者为治疗组, 另外40例非行MULP腹腔镜前列腺癌根治术患者为对照组, 在手术前两组患者年龄、平均BMI、既往史 (糖尿病) 、术前NHT、前列腺体积、术前前列腺特异性抗原 (PSA) 、术前Gleason评分、术前病理T分期均无统计学意义 (P>0.05) 。比较治疗组与对照组手术时间、切缘阳性率、前列腺尖部切缘阳性率、术后PSA (ng/ml) 、术后Gleason评分、并发症率及两组患者术后1、3、6、12个月尿控恢复情况、国际尿失禁咨询委员会尿失禁问卷表简表 (ICI-QSF) 评分情况。结果:两组患者手术都成功完成, 两组术后3、6、12个月并发症发生率、切缘阳性率、前列腺尖部切缘阳性率及PSA<0.2ng/ml的比率差异均无统计学意义 (P>0.05) 。两组术后1、3个月尿控恢复人数和ICIQ-SF评分情况差异均有统计学意义 (P<0.05);术后6、12个月的尿控恢复人数和ICI-Q-SF评分情况差异均无统计学意义 (P>0.05) 。结论:行MULP的腹腔镜前列腺癌根治术有利于术后早期尽快恢复尿控, 且不增加切缘阳性率。Abstract: Objective:To study the significance of maximal urethral length preservation (MULP) laparoscopic prostatectomy on postoperative continence restoration as soon as possible.Method:The 80 cases between February 2013 and March 2015 in our hospital were completed laparoscopic prostate cancer radical resection.The clinical data were retrospectively analyzed.Forty cases undergoing MULP laparoscopic prostate cancer radical operation were recorded as treatment group, and other 40 cases undergoing laparoscopic radical resection of non MULP were denoted as the controls.Preoperative data of two groups including patients' age, mean BMI, past history of diabetes, preoperative NHT, prostate volume, PSA, Gleason score and pathological T staging showed no statistical difference (P>0.05).Postoperative data including operation time, cutting margin positive rate, the apex of the prostate resection margin positive rate, PSA, Gleason score and complication, 1, 3, 6, 12 months of urinary continence recovery and ICI-Q-SF rating scale scores were compared between the control group and the treatment group.Result:Two groups of patients were successfully completed surgery.There was no significant difference in cutting margin positive rate, prostate apex of cutting margin positive rate, PSA<0.2 ng/ml ratio and complications of postoperative 3 months, 6 months, 12 months respectively between two groups (P>0.05).However, postoperative 1month and 3 months urinary continence restoration and ICI-Q-SF rating scale scores showed statistical significance (P<0.05).No statistically significant difference was found in 6 and 12 months of postoperative urinary continence restoration and ICI-Q-SF rating scale scores (P>0.05).Conclusion:MULP of laparoscopic radical prostatectomy is favourable to postoperative urinary continence restoration as quick as possible for prostate cancer patients, but does not increase the cutting margin positive rate.
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