标题:改良Veil保留神经技术对腹腔镜前列腺癌根治术后患者控尿和勃起功能的影响
作者:王斌,黎鼎荣,车斯策,陈存波,陈尧光 广东医科大学附属第二医院泌尿外科,广东 湛江 524003
卷次:
2021年32卷4期
【摘要】 目的 探讨改良Veil保留神经技术对腹腔镜前列腺癌根治术后患者的控尿和勃起功能的影响,为患者诊疗提供依据。方法 回顾性分析2017年1月至2020年1月广东医科大学附属第二医院泌尿外科收治的53例前列腺癌患者的诊疗情况。根据治疗方法不同分为观察组28例和对照组25例。观察组采用改良Veil保留神经技术治疗,对照组采用常规腹腔镜手术治疗。比较两组患者的手术情况、治疗前后国际尿失禁咨询委员会尿失禁问卷表(ICIQ-SF)评分、扩展前列腺癌复合指数(EPIC-UIN)、1 h尿垫测定、国际勃起功能问卷量表(IIEF-5)评分、国际前列腺症状评分(IPSS)以及并发症发生情况。结果 观察组患者的尿管留置时间、住院时间分别为(6.12±1.02) d、(10.13±2.11) d,明显短于对照组的(8.12±1.33) d、(13.25±2.37) d,差异均有统计学意义(P<0.05);治疗后,两组患者的ICIQ-SF、1h尿垫测试分别为(6.19±1.01)分、(12.41±2.10)g,明显低于对照组的(8.12±1.08)分、(18.46±3.02) g,而EPIC-UIN评分为(87.12±6.17)分,明显高于对照组的(78.23±6.29)分,差异均有统计学意义(P<0.05);治疗后,观察组患者的 IIEF-5评分为(17.47±1.02)分,明显高于对照组的(11.29±1.32)分,而 IPSS评分为(12.10±1.05)分,明显低于对照组的(16.25±1.27)分,差异均有统计学意义(P<0.05);观察组患者的并发症发生率为 8.14%,明显低于对照组的28.00%,差异有统计学意义(P<0.05)。结论 改良Veil保留神经技术对腹腔镜前列腺癌根治术的损伤小,可有效改善患者的控尿效果,保护性功能,减少并发症,具有较高的临床应用价值。
【关键词】 前列腺癌;腹腔镜;改良Veil保留神经技术;控尿;性功能;并发症
【中图分类号】 R737.25 【文献标识码】 A 【文章编号】 1003—6350(2021)04—0468—04
Effect of modified Veil nerve preservation technique on urine control and erectile function after laparoscopicradical prostatectomy.
WANG Bin, LI Ding-rong, CHE Si-ce, CHEN Cun-bo, CHEN Yao-guang. Department of UrologySurgery, the Second Affiliated Hospital of Guangdong Medical University, Zhanjiang 524003, Guangdong, CHINA
【Abstract】 Objective To explore the effect of modified Veil nerve preservation technology on the urinary con-trol and erectile function of patients after laparoscopic radical prostatectomy, and to provide basis for the diagnosis andtreatment of patients. Methods The diagnosis and treatment of 53 prostate cancer patients admitted to Department ofUrology Surgery, the Second Affiliated Hospital of Guangdong Medical University from January 2017 to January 2020were analyzed retrospectively. According to different treatment methods, they were divided into the observation group(n=28) and control group (n=25). The observation group was treated with modified Veil nerve preservation technique,and the control group was treated with conventional laparoscopic surgery. The surgical status, the International Inconti-nence Advisory Committee Urinary Incontinence Questionnaire (ICIQ-SF) score before and after treatment, the ex-panded prostate cancer composite index (EPIC-UIN), the 1 h urine pad measurement, and the International ErectileFunction Questionnaire (IIEF-5) Score, International Prostate Symptom Score (IPSS) and complications of the twogroups were compared. Results The catheter indwelling time and length of hospital stay in the observation groupwere (6.12±1.02) d and (10.13±2.11) d, which were significantly shorter than corresponding (8.12±1.33) d and (13.25±2.37) d of the control group (P<0.05); after treatment, the ICIQ-SF and 1 h urine pad tests of the two groups were(6.19 ± 1.01) points and (12.41 ± 2.10) g, which were significantly lower than corresponding (8.12 ± 1.08) points and(18.46±3.02) g of the control group, while the EPIC-UIN score was (87.12±6.17) points, which was significantly higherthan (78.23±6.29) points in the control group (all P<0.05); after treatment, the IIEF-5 score of the observation group was(17.47±1.02) points, which was significantly higher than (11.29±1.32) points of the control group, while the IPSS scorewas (12.10±1.05) points, which was significantly lower than (16.25±1.27) points of the control group (P<0.05); and thecomplication rate of the observation group was 8.14%, which was significantly lower than 28.00% of the control group(P<0.05). Conclusion The modified Veil nerve preservation technique has little damage to laparoscopic radical prosta-tectomy, can effectively improve the patient's urinary control effect, protect function, reduce complications, and has highclinical application value.
【Key words】 Prostate cancer; Laparoscopy; Modified Veil nerve preservation technique; Urine control; Sexualfunction; Complications
下载PDF