中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2012年
7期
512-514
,共3页
张志宏%刘冉录%乔宝民%杨阔%马宝杰%徐勇
張誌宏%劉冉錄%喬寶民%楊闊%馬寶傑%徐勇
장지굉%류염록%교보민%양활%마보걸%서용
盆腔双叶拉钩%血管蒂%显露%膀胱切除术%前列腺切除术
盆腔雙葉拉鉤%血管蒂%顯露%膀胱切除術%前列腺切除術
분강쌍협랍구%혈관체%현로%방광절제술%전렬선절제술
Pelvic double-slice retractor%Vascular pedicle%Exposure%Cystectomy%Prostatectomy
目的 探讨男性复杂盆腔患者膀胱和前列腺血管蒂处理方法的改进效果. 方法 男性膀胱癌患者43例.年龄49～75岁,平均58岁.30例体质指数(BMI)28.8～31.3 kg/m2,平均29.7 kg/m2.曾行膀胱部分切除术16例(同时行输尿管膀胱再植术4例).43例均行B超、CT、膀胱镜检查.肿瘤单发8例,多发35例.肿瘤最大径1.6～4.5 cm,平均3.6 cm.均经病理证实为膀胱癌.临床分期:T2期30例,T3期13例.前列腺癌37例.年龄54～72岁,平均65岁.BMI 29.5～32.7 kg/m2,平均30.6 kg/m2.临床分期:T2a期10例,T2b期25例,T3a期2例.患者分别行根治性膀胱切除术(RC)及顺行根治性前列腺切除术(ARP),术中辅助应用盆腔双叶拉钩进行膀胱及前列腺血管蒂显露. 结果 80例手术均顺利完成.在盆腔双叶拉钩提供的良好显露条件下,膀胱及前列腺血管蒂处理准确、快速.无直肠及盆壁组织损伤.RC组处理血管蒂时间9～14 min,平均12 min；出血量20～50 ml,平均30 ml.ARP组处理血管蒂时间5～9 rmin,平均7 min；出血量10～35 ml,平均20 ml. 结论 盆腔双叶拉钩结构简单、操作方便、使用性能好,男性复杂盆腔患者ARP和RC术中辅助应用盆腔双叶拉钩行膀胱及前列腺血管蒂显露效果满意.
目的 探討男性複雜盆腔患者膀胱和前列腺血管蒂處理方法的改進效果. 方法 男性膀胱癌患者43例.年齡49～75歲,平均58歲.30例體質指數(BMI)28.8～31.3 kg/m2,平均29.7 kg/m2.曾行膀胱部分切除術16例(同時行輸尿管膀胱再植術4例).43例均行B超、CT、膀胱鏡檢查.腫瘤單髮8例,多髮35例.腫瘤最大徑1.6～4.5 cm,平均3.6 cm.均經病理證實為膀胱癌.臨床分期:T2期30例,T3期13例.前列腺癌37例.年齡54～72歲,平均65歲.BMI 29.5～32.7 kg/m2,平均30.6 kg/m2.臨床分期:T2a期10例,T2b期25例,T3a期2例.患者分彆行根治性膀胱切除術(RC)及順行根治性前列腺切除術(ARP),術中輔助應用盆腔雙葉拉鉤進行膀胱及前列腺血管蒂顯露. 結果 80例手術均順利完成.在盆腔雙葉拉鉤提供的良好顯露條件下,膀胱及前列腺血管蒂處理準確、快速.無直腸及盆壁組織損傷.RC組處理血管蒂時間9～14 min,平均12 min；齣血量20～50 ml,平均30 ml.ARP組處理血管蒂時間5～9 rmin,平均7 min；齣血量10～35 ml,平均20 ml. 結論 盆腔雙葉拉鉤結構簡單、操作方便、使用性能好,男性複雜盆腔患者ARP和RC術中輔助應用盆腔雙葉拉鉤行膀胱及前列腺血管蒂顯露效果滿意.
목적 탐토남성복잡분강환자방광화전렬선혈관체처리방법적개진효과. 방법 남성방광암환자43례.년령49～75세,평균58세.30례체질지수(BMI)28.8～31.3 kg/m2,평균29.7 kg/m2.증행방광부분절제술16례(동시행수뇨관방광재식술4례).43례균행B초、CT、방광경검사.종류단발8례,다발35례.종류최대경1.6～4.5 cm,평균3.6 cm.균경병리증실위방광암.림상분기:T2기30례,T3기13례.전렬선암37례.년령54～72세,평균65세.BMI 29.5～32.7 kg/m2,평균30.6 kg/m2.림상분기:T2a기10례,T2b기25례,T3a기2례.환자분별행근치성방광절제술(RC)급순행근치성전렬선절제술(ARP),술중보조응용분강쌍협랍구진행방광급전렬선혈관체현로. 결과 80례수술균순리완성.재분강쌍협랍구제공적량호현로조건하,방광급전렬선혈관체처리준학、쾌속.무직장급분벽조직손상.RC조처리혈관체시간9～14 min,평균12 min；출혈량20～50 ml,평균30 ml.ARP조처리혈관체시간5～9 rmin,평균7 min；출혈량10～35 ml,평균20 ml. 결론 분강쌍협랍구결구간단、조작방편、사용성능호,남성복잡분강환자ARP화RC술중보조응용분강쌍협랍구행방광급전렬선혈관체현로효과만의.
Objective To evaluate effectiveness of the applying pelvic double-slice retractor in the division of bladder and prostate pedicles in male patients with previous surgery history during radical cystectomy (RC) and anterograde radical prostatectomy (ARP). Methods The pelvic double-slice retractor was used to expose the bladder and prostate pedicles in 43 RC (30 cases with BMI ＞ 28 kg/m2,16 cases had previous partial cystectomy) and 37 ARP ( all cases with BMI ＞ 28 kg/m2 ). Results The pelvic double-slice retractor provided excellent exposure for the division of bladder and prostate pedicles.The handling of bladder and prostate pedicles became easy and safe without unnecessary bleeding and injury to the rectum.The median operating time to control the pedicles during RC and ARP were 12 min and 7 min,and the average blood loss were 30 ml and 20 ml,respectively. Conclusion The use of pelvic double-slice retractor for the exposure of the bladder and prostate pedicles is simple and effective in male patients with complicated pelvic anatomy during RC and ARP.
