腹腔镜单纯尿道前壁加强法与尿道前后壁加强法(Sandwich法)改善前列腺癌根治术后早期尿控的对比分析

目的 探讨腹腔镜单纯尿道前壁悬吊加强法和尿道前后壁加强法对前列腺癌根治术后早期尿控的疗效。方法 纳入自2014年2月至2019年12月，首都医科大学附属北京朝阳医院泌尿外科收治的99例前列腺癌患者，其中56例采用尿道前后壁加强法治疗，43例采用单纯尿道前壁悬吊加强法治疗，比较两组患者的年龄、体质量指数、前列腺体积、术前前列腺特异性抗原（prostate specific antigen，PSA），临床分期、手术时间、病理分期、Gleason评分、淋巴结阳性率、术后切缘阳性率及通过电话随访拔除尿管后第2、4、12、24、52周时的尿控恢复情况。结果 两组患者的年龄、体质量指数、前列腺体积、PSA、临床分期、手术时间、病理分期、Gleason评分、淋巴结阳性率、术后切缘阳性率差异均无统计学意义（P>0.05），拔除尿管后第12周可见单纯尿道前壁悬吊加强法的治疗效果优于尿道前后壁加强法，但各指标差异仍无统计学意义（P=0.058）。结论 腹腔镜前列腺癌根治术中采用前壁加强缝合悬吊法安全易行，与前后壁双重加强的方法相比，疗效接近。

Comparative analysis of the improvement of early urinary control after radical prostatectomy by laparoscopic anterior urethral wall reconstruction and "Sandwich" reconstruction

Objective To investigate the effect of laparoscopic anterior urethral wall reconstruction and "Sandwich" reconstruction on early urinary control after radical prostatectomy. Methods A total of 99 patients with prostate cancer were enrolled from February 2014 to December 2019. Totally 56 patients were treated with "Sandwich" reconstruction, and 43 patients were treated with laparoscopic anterior urethral wall reconstruction. It was compared between the two groups with the age, body mass index, prostate volume, preoperative prostate specific antigen (PSA), clinical stage, operation time, pathological stage, Gleason score, lymph node positive rate, postoperative incisal margin positive rate and peripheral urinary control recovery. Results There was no significant difference in age, body mass index, prostate volume, PSA, clinical stage, operation time, pathological stage, Gleason score, lymph node positive rate, and postoperative incisors positive rate (P>0.05). At the 12th week after pulling out the urethral catheter, it was observed that the laparoscopic anterior urethral wall reconstruction was superior to the "Sandwich" reconstruction, but without statistically significance (P=0.058). Conclusion It is safe and easy to use the anterior urethral wall reconstruction in laparoscopic radical prostatectomy, which is superior to the"Sandwich" reconstruction.