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目的:总结两种不同的尿道膀胱颈吻合方法对腹腔镜前列腺癌根治术的影响。方法:2009年1月～2010年3月我科对52例早期局灶性前列腺癌实施经腹膜外腹腔镜前列腺癌根治术,手术采用经腹膜外入路。患者随机分成两组,一组20例采用间断缝合方法,另一组32例采用连续缝合方法。首先将两根15 cm长3-0可吸收肠线末端打结固定,于膀胱颈6点处将两针自膀胱浆膜层向黏膜层穿出,线结位于浆膜层外并拉紧,两针分别向9点、3点方向与尿道吻合,最后在12点处将两线打结,完成吻合。结果:52例腹腔镜前列腺癌根治术均获成功,无一例中转开放手术。间断缝合组:尿道膀胱吻合用时25～41 min,平均32.6 min;出现短时间吻合口漏2例,分别为2天和3天;连续缝合组:尿道膀胱吻合用时11～27 min,平均17.7 min;出现短时间吻合口漏1例,2天后好转。结论:连续缝合方法可缩短手术时间,减少漏尿发生率。
Objective: To summarize the effects of two different methods of urethral bladder neck anastomosis on laparoscopic radical prostatectomy. Methods: From January 2009 to March 2010, 52 cases of early-stage focal prostate cancer underwent radical retroperitoneal laparoscopic radical prostatectomy in our department. The surgery was performed by extraperitoneal approach. Patients were randomly divided into two groups, one group of 20 cases using intermittent suture method, and the other 32 cases of continuous suture method. First, two 15 cm long 3-0 absorbable gut ends tied knot fixed at the bladder neck at 6 o’clock two needles from the bladder serosal layer to the mucosal layer piercing, line junction located in the serosa and tightening, The two needles were respectively anastomosed to the urethra at 9 o’clock and 3 o’clock, and the two knots were finally tied at 12 o’clock to complete the anastomosis. Results: 52 cases of laparoscopic radical prostatectomy were successful, no case of transfer to open surgery. Intermittent suture group: urinary bladder anastomosis with 25 ~ 41 min, an average of 32.6 min; a short time anastomotic leakage in 2 cases, respectively, 2 days and 3 days; continuous suture group: urethral anastomosis with 11 ~ 27 min, an average of 17.7 min A short time anastomotic leakage in 1 case, 2 days after the improvement. Conclusion: Continuous suture method can shorten the operation time and reduce the incidence of leakage of urine.