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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。
Objective: To investigate the clinical significance of maximal urethral length preservation (MULP) in resuming urinary control after laparoscopic radical prostatectomy. Methods: The clinical data of 80 cases of laparoscopic radical prostatectomy from February 2013 to March 2015 in our hospital were retrospectively analyzed. The patients were followed up until March 2016. Among them, 40 patients underwent MULP laparoscopic radical prostatectomy for the treatment group and another 40 patients underwent non-compliance MULP laparoscopic radical prostatectomy as the control group. Before operation, the patients’ age, mean BMI, prior history (diabetes) Pre-NHT, prostate volume, preoperative prostate-specific antigen (PSA), preoperative Gleason score, preoperative pathological T stage were not statistically significant (P> 0.05). The operative time, positive margins of the margins, positive margins of the prostatic apex, postoperative PSA (ng / ml), postoperative Gleason score and postoperative complication rates were compared between the two groups , 12 months urinary control recovery, the International Council on Urinary Incontinence Urinary incontinence questionnaire summary (ICI-QSF) score. Results: The operation of both groups was successfully completed. There was no difference in the incidence of complications, the positive rate of the margin, the positive rate of the prostatic anterior margin and the PSA <0.2ng / ml at 3, 6, and 12 months after operation Statistical significance (P> 0.05). There were significant differences in urinary control recovery and ICIQ-SF score between the two groups at 1 and 3 months after operation (P <0.05). Urine control recovery and ICI-Q-SF score at 6 and 12 months after operation There was no significant difference (P> 0.05). Conclusions: Laparoscopic radical prostatectomy with MULP is helpful for the recovery of urinary control as soon as possible after operation and does not increase the positive rate of margins.