Clinical Application Of Urethral Dragging And Anastomosis In Laparoscopic Radical Cystectomy And Ileal In Situ Neobladder

Objective:To evaluate the modified technique of bladder urethra anastomosis were performed by Floey urethral catheter guided urethral pull and traditional interrupted suture in laparoscopic radical cystectomy with ileal orthotopic neobladder.Method:Retrospective analysis of 41 patients with invasive bladder cancer with laparoscopic radical cystectomy with orthotopic ileal neobladder in Department of Urology,Jiangxi People's Hospital during the period of 2013-12~2017-12.All patients underwent cystoscopy before operation and diagnosed as muscle-invasive bladder cancer by cystoscopic biopsy.All patients underwent laparoscopic radical cystectomy and orthotopic ileal neobladder and were divided into A and B groups randomly,group A,19 patients were treated with the method of laparoscopic urethral trailing and anastomosis for Vesicourethral anastomosis,group B,21 patients as control group,underwent the bladder and urethra were anastomosed by conventional interrupted suture after complete cystectomy.At last,the complications of two groups of patients were compared with the time of bladder urethral anastomosis,the time of urethral catheterization after operation,and postoperative anastomotic leakage,and two different methods were compared in the laparoscopic radical cystectomy and ileum in situ new bladder operation.Finally,two groups of patients with bladder urethra anastomosis time,postoperative removal of catheter time,Postoperative anastomotic leakage and other complications were compared,and the curative effect of the two different methods was compared.Result:All 41 cases were successful.The results showed that there was no significant difference in age,sex and other general information before and after operation in the two groups(P > 0.05).In the experimental group(A group),the time between the storage of the allantoic sac and the urethra was an average of 15.51 minutes.The control group(B group)had an average anastomosis time of 16.61,and the experimental group shortened the time of anastomosis effectively(P<0.05).There was no significant difference in the time of catheter removal,the incidence of urinary leakage,the incidence of anastomotic stenosis and the incidence of urinary incontinence between the two groups(P>0.05).Conclusion:Compared with conventional interrupted suture anastomosis,the urethral trailing and anastomosis method has reliable curative effect,can shorten the anastomosis time,is simple and feasible,has a short learning curve,and is highly repeatable.The incidence of postoperative anastomotic complications does not increase significantly.