| Research background:With the improvement of diagnosis and treatment technology,more and more early localized prostate cancer patients have been found.Young patients are required to have a higher quality of life after radical prostatectomy.With the continuous optimization and improvement of surgical methods for radical prostatectomy,a series of surgical methods have been developed to improve the urinary control and erectile function of patients after operation.Among them,reasonable treatment of back depth is needed.Venous complex directly affects the prognosis of patients with cancer.This paper studies the effect of laparoscopic operation of deep dorsal vein complex with suture and non-suture on urinary control and erectile function of patients with prostate cancer after operation,to determine which surgical method is used to obtain greater benefits for patients.Objective:To compare the clinical efficacy of laparoscopic radical prostatectomy with or without deep dorsal vein complex(DVC)for prostate cancer,so as to select a more suitable surgical method for early localized prostate cancer patients.Methods:The clinical data and follow-up data of 45 cases of laparoscopic radical prostatectomy with deep dorsal vein complex ligation and non-ligation performed by the same surgeon from January 2015 to June 2018 were retrospectively analyzed.The follow-up time was 6 months.Clinical data included age,body mass index(BMI),PSA,Gleason score,clinicopathological stage,positive rate of incision margin,operation time,intraoperative bleeding volume and intraoperative blood transfusion.Postoperative follow-up included recovery of urinary control at 1 week,1 month,3 months and 6 months after removal of ureter,recovery of erectile function at 1 week,1 month,3 months and 6 months after operation.Situation.We divided them into two groups according to different surgical methods:24 cases of laparoscopic prostatectomy with DVC suture(group A)and 21 cases of laparoscopic prostatectomy without DVC suture(group B).Methods SPSS 22.0 was used to carry out data statistics.The measurement data were expressed by x±s,the comparison between groups was expressed by t test,the utilization rate of counting data was expressed by t test,and the comparison between groups was expressed byx2 test or Fisher precision probability test.P<0.05 was statistically significant.Results:Forty-five patients with prostate cancer were successfully operated on.There were no significant differences in age,BMI,PSA,Gleason score and positive rate of surgical margin between the two groups.The operation time of DVC group and DVC non-suture group were(165.83±82.30)min and(126.19 ±46.63)min respectively(P>0.05);the intraoperative blood loss was(158.33±136.47)ml and(169.05±190.05)ml(P>0.05);the intraoperative blood transfusion rate was 0%and 4.8%(P>0.05);the pathological features of the specimens after operation were alveolar adenocarcinoma of prostate,and the positive rate of resection margin was 25.0%,19.0%,respectively.(P>0.05);the incidence of urinary incontinence was 54.2%and 23.8%at 6 months after operation(P=0.038);the erectile function at 6 months after operation(morning erection)was 41.7%and 71.4%(P=0.045).Conclusion:The results showed that the recovery of postoperative continenece and erectile function of patients with prostate cancer in the suture-free DVC group was significantly better than that in the suture-free DVC group at 6 months.There was no significant difference in operative time,intraoperative bleeding volume,intraoperative blood transfusion and positive rate of incision margin between the suture-free DVC group and the suture-free DVC group.Therefore,for early localized prostate cancer patients whose age is less than 75 years old,PSA is less than 25 ng/ml,clinical stage is T2a-T2c,and erectile function is normal before operation(all have morning erection),we recommend a suture-free DVC laparoscopic radical prostatectomy for prostate cancer. |
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