本文選題：前列腺癌 + 腹腔鏡�。� 參考：《大連醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：比較腹腔鏡前列腺癌根治術(shù)中不同的膀胱尿道吻合方式對(duì)術(shù)后吻合口并發(fā)癥的影響。 方法：2011年2月~2013年9月我科對(duì)66例臨床局限性前列腺癌實(shí)施腹腔鏡前列腺癌根治術(shù)，手術(shù)采用經(jīng)腹腔入路�；颊吒鶕�(jù)吻合方式不同分為兩組，一組24例采用間斷縫合的膀胱尿道吻合方式，另一組42例采用連續(xù)縫合方式。比較兩種手術(shù)方法的手術(shù)時(shí)間、術(shù)后吻合口漏尿、拔管后吻合口狹窄及一個(gè)月、三個(gè)月、六個(gè)月的尿失禁情況的差異。 結(jié)果：66例腹腔鏡前列腺癌根治術(shù)均獲成功，無(wú)一例中轉(zhuǎn)開放手術(shù)。間斷縫合組：尿道膀胱吻合用時(shí)27~40min，平均35.7min；出現(xiàn)吻合口漏尿3例，分別于術(shù)后3~6天出現(xiàn)，漏尿2~4天后愈合；留置導(dǎo)尿2周拔除尿管后一個(gè)月，2例出現(xiàn)排尿困難，再次留置導(dǎo)尿一周后排尿好轉(zhuǎn)；術(shù)后一個(gè)月隨診15例控尿良好，9例出現(xiàn)尿失禁；三個(gè)月隨診19例控尿良好，5例出現(xiàn)尿失禁；六個(gè)月隨診21例控尿良好，3例出現(xiàn)尿失禁。連續(xù)縫合組：尿道膀胱吻合用時(shí)15~25min，平均20.5min；出現(xiàn)吻合口漏尿2例，分別于術(shù)后3天、5天出現(xiàn)，漏尿2天后愈合；留置導(dǎo)尿2周拔除尿管后一個(gè)月，1例出現(xiàn)排尿困難，再次留置導(dǎo)尿一周后排尿好轉(zhuǎn)；術(shù)后一個(gè)月隨診33例控尿良好，9例出現(xiàn)尿失禁；三個(gè)月隨診40例控尿良好，，2例出現(xiàn)尿失禁；六個(gè)月隨診41例均控尿良好，僅1例出現(xiàn)尿失禁。 結(jié)論：腹腔鏡前列腺癌根治術(shù)中采用連續(xù)縫合的膀胱尿道吻合方式較間斷縫合可縮短手術(shù)時(shí)間，降低吻合口漏尿、吻合口狹窄及尿失禁等并發(fā)癥的發(fā)生率。
[Abstract]:Objective : To compare the effects of different bladder urethral anastomosis on postoperative anastomotic complications in laparoscopic radical prostatectomy .

Methods : From February 2011 to September 2013 , we performed laparoscopic radical prostatectomy for 66 cases of clinical localized prostate cancer . The patients were divided into two groups according to the anastomosis method .

Results : 66 cases of laparoscopic radical prostatectomy were successful and none of them were open to open surgery . The interrupted suture group : 27 to 40 minutes at the time of anastomosis of the urethra bladder , and the average was 35.7min ;
There were 3 cases of anastomotic leakage , 3 - 6 days after operation and 2 - 4 days after leakage .
One month after the urinary catheter was removed after 2 weeks of catheterization , 2 cases had difficulty in urination , and after another week of catheterization , the urination was improved ;
One month after operation , 15 cases were treated with good urine and 9 cases had urinary incontinence ;
Three months follow - up 19 cases with good control of urine , 5 cases of urinary incontinence ;
Twenty - six months follow - up in 21 cases with good control of urine and 3 cases of urinary incontinence . Continuous suture group : 15 - 25 min at the time of anastomosis of urethra bladder , average 20.5 min ;
There were 2 cases of anastomotic leakage , 3 days after operation , 5 days after operation and 2 days after leakage of urine ;
One month after the urinary catheter was removed for 2 weeks , one patient had difficulty in urination , and after another week of catheterization , the urination was improved .
One month after operation , 33 cases had better control of urine and 9 cases had urinary incontinence ;
In the last three months , 40 cases had better control of urine and 2 cases had urinary incontinence ;
There were 41 cases with good control of urine in six months , and only 1 case had urinary incontinence .

Conclusion : The operation time can be shortened and the incidence of complications such as anastomotic leakage , anastomotic stenosis and urinary incontinence can be reduced by continuous suture in laparoscopic radical prostatectomy .
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.25

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