機器人手臂協助腹腔鏡攝護腺全切除後之後重建併懸吊技術來增進早期控尿: 我們醫院的經驗
李高漢、黃冠華1、賴韋宏、 劉建良、洪順興
奇美醫學中心 外科部 泌尿外科 ，1泌尿腫瘤科
Posterior reconstruction with suspension technique to improve early continence after robotic-assisted laparoscopic radical prostatectomy: our hospital experience
Kau Han Lee, Steven Kuan-Hua Huang1, Wei-Hong Lai, Chien-Liang Liu, Shun-Hsing Hung
Division of Urology, Department of Surgery, 1Division of Uro-Oncology
Chi-Mei Medical Center, Tainan, Taiwan
Introduction and purpose: Urinary incontinence is a significant cause of morbidity after radical prostatectomy. We present our experience of posterior reconstruction with suspension technique to improve early continence after robotic-assisted radical prostatectomy
Materials & Methods: From 2012 April to 2014 April, 50 patients underwent robotic-assisted transperitoneal laparoscopic radical prostatectomy. After the prostatectomy & prior of the urethrovesical anastomosis, posterior reconstruction was enhanced by reapproximating rhabdosphincter to the residual Denonvillier’s fascia & secured over pubic symphisis with 3-0 V-Loc suture. The continence was defined as no pad use in daily life.
Results: The mean age was 65 year-old. The mean PSA was 20.8ng/ml. The mean prostate size was 33gm. The medium console time was 226mins. Nerve sparing procedure was performed bilaterally in 19 (38%) & unilaterally in 7(14%) cases. The 1 week, 1 month, 3 month & 6 month continence rate were 30.6%, 61.2%, 87.8 & 95.9% respectively.
Conclusion: Posterior reconstruction with suspension technique after robotic-assisted radical prostatectomy is a feasible technique to improve early continence rate, thus decreasing patient’s postoperative morbidity.