Laparoscopic surgery for high-risk prostate cancer: urinary and oncologic outcomes of vesicourethral anastomosis with maximal urethral length and bladder neck preservation
10.3969/j.issn.1009-8291.2024.07.010
- VernacularTitle:腹腔镜下前列腺癌根治术联合保留最大尿道长度和膀胱颈的尿道重建术治疗高危前列腺癌的早期控尿和控瘤效果
- Author:
Kun ZHENG
1
;
Xiaoyong HU
1
;
Qiang FU
1
;
Wang LI
1
;
Ying WANG
1
;
Nailong CAO
1
;
Jiasheng CHEN
1
;
Ranxing YANG
1
Author Information
1. Department of Urology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200233, China
- Publication Type:Journal Article
- Keywords:
prostate cancer;
laparoscopic radical prostatectomy;
robot-assisted laparoscopic radical prostatectomy;
urinary incontinence;
maximal urethral length;
bladder neck;
vesicourethral anastomosis;
urethral reconstruction
- From:
Journal of Modern Urology
2024;29(7):612-616
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To explore the application value of vesicourethral anastomosis with maximal urethral length preservation (MULP) and bladder neck preservation (BNP) in laparoscopic radical prostatectomy (LRP) or robot-assisted laparoscopic radical prostatectomy (RALP) for high-risk prostate cancer (HRPC) in terms of early urinary continence and oncology. 【Methods】 Clinical data of 23 HRPC patients who underwent LRP (including RALP) with MULP and BNP in our hospital during May 2022 and Jan.2024 were retrospectively analyzed.Patients’ basic information, surgical parameters, postoperative complications, oncological outcomes and urinary incontinence were collected and analyzed. 【Results】 All operations were completed successfully without conversion to open surgery.The operation time was (108±31) min, average blood loss (112±45) mL, hospital stay (5.5±1.5) days, urethral catheterization time (12.6±1.8) days, and no patient received blood transfusion during operation.The urinary continence rates at the time of catheter removal, and at 1, 3, and 6 months after surgery were 39.1%, 65.2%, 73.9%, and 91.3%, respectively.Two patients had positive margins, both of which were at the neurovascular bundle.No patient developed surgery-related complications, urinary obstruction or fistula after surgery. 【Conclusion】 Vesicourethral anastomosis with MULP and BNP in LRP for HRPC can effectively improve patients’ early urinary continence rate and postoperative quality of life without increasing the oncological risk.
