1.Urinary continence-related structures and intraoperative protective techniques in radical prostatectomy
Minxin HE ; Geng TIAN ; Tie CHONG ; Delai FU
Journal of Modern Urology 2023;28(12):1086-1091
Radical prostatectomy (RP) is the standard treatment for patients with early-stage of prostate cancer,but often causes urinary incontinence and other complications, which harm patients’ quality of life. The protection and reconstruction of urinary continence-related structures during the operation are significant approaches to reduce the incidence of urinary incontinence and restore urinary continence. This article reviewed the surgical approaches of radical prostatectomy, anatomy of urinary continence-related structures (bladder neck, functional urethra, supporting structures, nerves and vessels) and the protective skills,hoping to provide reference for the treatment of early-stage prostate cancer.
2.Artery anatomy of localized renal cell carcinoma: an initial study based on 3D Slicer software
Ke GAO ; Ziyan WAN ; Ya ZHANG ; Hui ZHANG ; Xiaojie YANG ; Tie CHONG ; Delai FU
Journal of Modern Urology 2024;29(4):298-301
【Objective】 To analyze the position of the feeding artery entering the renal cell carcinoma (RCC) with 3D Slicer software, so as to explore the distribution pattern of the tumor artery and to provide an anatomical basis for the accurate surgical resection. 【Methods】 The clinical data of RCC patients who underwent partial nephrectomy in the Department of Urology, The Second Affiliated Hospital of Xi'an Jiaotong University during Jan.2021 and Jun.2022 were collected.The preoperative renal artery CT angiography data were imported into 3D Slicer software in DICOM format to construct the relative positions of tumor-feeding artery from horizontal, sagittal and coronary planes.The number and distribution of tumor feeding arteries in each plane were analyzed. 【Results】 A total of 112 patients (59 male and 53 female) with single tumor were involved.RENAL score was 4-10.The tumor stages were T1a in 58 cases, T1b in 48 cases, and T2a in 6 cases.Among them, 38 cases (33.93%) had 1 tumor artery, 53 cases (47.32%) had 2 tumor arteries, and 21 cases (18.75%) had 3 tumor arteries.Of these 207 tumor arteries, 22 (10.63%) entered the tumor through the superficial part of the tumor bed, and 185 (89.37%) through the deep part. 【Conclusion】 In localized RCC, nearly 90% of the feeding arteries enter the tumor from deep part of the tumor bed, which provides an anatomical basis for accurate tumor resection and wound suture in partial nephrectomy.
3.Transvesical robot-assisted radical prostatectomy: a report of 13 cases
Hang BI ; Delai FU ; Jianping LI ; Xiaoshuang TANG ; Haiwen CHEN ; Qidong LUO ; Qi CHEN ; Ning NAN ; Li WANG ; Tie CHONG ; Zhaolun LI
Journal of Modern Urology 2023;28(5):413-416
【Objective】 To share the technical key points and experience of transvesical robot-assisted radical prostatectomy (TvRARP). 【Methods】 The clinical data of 13 patients with prostate cancer (PCa) receiving TvRARP during Nov.2021 and May 2022 were collected. The operation time, estimated blood loss, blood transfusion rate, catheter removal time, postoperative length of hospital stay, immediate urinary continence rate, postoperative IIEF-5 score and perioperative complications were evaluated. 【Results】 The operation time was (142±39) min, estimated intraoperative blood loss was (76±40) mL, and no transfusion was needed. The median postoperative IIEF-5 score was 16 (12-22), hospital stay 3 (2-5)days, and catheter removal time 7(5-14)days. Of all 13 patients, 12(92.3%) achieved immediate urinary continence at the removal of catheter. There were no postoperative complications of Clavien Ⅲ and above. Clavien Ⅰ-Ⅱ complications were observed in 4 patients (30.8%). 【Conclusion】 TvRARP is feasible and safe for selected patients with clinically localized PCa, which can ensure promising postoperative urinary continence and preserve erectile functional.