术中保留耻骨前列腺韧带对行机器人辅助腹腔镜前列腺癌根治术老年患者的影响OA
The effect of preserving the pubic prostatic ligament during surgery on elderly patients undergoing robot-assisted laparoscopic radical prostatectomy
目的 探讨术中保留耻骨前列腺韧带对行机器人辅助腹腔镜前列腺癌根治术(RALP)的老年患者术后膀胱功能及尿失禁的影响.方法 选取中国人民解放军联勤保障部队第九六○医院 2019 年6 月—2023 年6 月接受RALP 治疗的80 例老年前列腺癌患者进行回顾性分析,按照手术方案不同分为 A组(RALP 术中保留耻骨前列腺韧带,37 例)和 B 组(标准 RALP,43 例).比较两组的围术期相关指标、术后膀胱功能、尿失禁发生情况与严重程度、性功能及生活质量.结果 A 组总住院时间短于 B 组(P<0.05);两组手术时间、术中出血量、术后引流管留置时间、术后导尿管留置时间比较,差异均无统计学意义(P>0.05).随访6 个月时,A组最大尿流率、最大尿道压、膀胱顺应性等数据均大于B组,残余尿量少于B组(P<0.05);A组尿失禁发生率低于B组,尿失禁严重程度轻于B组(P<0.05);A组勃起功能国际问卷表-5 评分、中国早泄患者性功能评价表-10 评分、世界卫生组织生活质量测定简表各项评分均高于B组(P<0.05).结论 老年前列腺癌患者RALP 术中保留耻骨前列腺韧带可提高术后膀胱功能,降低尿失禁发生率,改善性功能与生活质量,可促进患者康复.
Objective To explore the effect of preserving the pubicprostato ligament(PPLs)during surgery on postopera-tive bladder function and urinary incontinence in elderly patients undergoing robot-assisted laparoscopic radical prostatectomy(RALP).Methods A total of 80 elderly patients with prostate cancer who received RALP treatment in the the 960th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation from June 2019 to June 2023 were retrospective collected.They were divided into a group A(37 cases,with puboprostatic Ligament preserved during RALP surgery)and a group B(43 cases,with stand-ard RALP surgery)according to different surgical plans.The perioperative related indicators,postoperative bladder function,incidence and severity of urinary incontinence,sexual function,and quality of life between the two groups were collected and compared.Results The total hospitalization time of group A was shorter than that of group B(P<0.05).The differences in the operation time,intraopera-tive blood loss,postoperative drainage tube indwelling time and postoperative catheter indwelling time between the two groups had no statistical significance(P>0.05).At 6 months follow-up,the maximum urinary flow rate,maximum urethral pressure,and bladder compliance in group A were higher than those in group B and the residual urine volume was lower than that in group B(P<0.05),the incidence of urinary incontinence in group A was lower than that in group B,and the severity of urinary incontinence was milder in group A than in group B(P<0.05),the scores of group A on the international inventory of erectile function-5,Chinese premature e-jaculation patient sexual function evaluation scale-10,and World Health Organization quality of life assessment brief were all higher than those of group B(P<0.05).Conclusion Retaining puboprostatic ligament during surgery in elderly patients with RALP can improve postoperative bladder function,reduce the incidence of urinary incontinence,improve sexual function and quality of life,and promote recovery.
周毅恒;宋华
中国人民解放军联勤保障部队第九六○医院,山东 济南 250031中国人民解放军联勤保障部队第九六○医院,山东 济南 250031
前列腺癌机器人辅助腹腔镜前列腺癌根治术耻骨前列腺韧带膀胱功能尿失禁
Prostate cancerRobot-assisted laparoscopic radical prostatectomyPuboprostatic ligamentBladder functionUrinary incontinence
《国际老年医学杂志》 2026 (2)
183-188,6
国家自然科学基金(81572875)
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