Controlled Clinical Trial Of Gia Stapler And Manual Suture In The Construction Of Mainz Ⅱ Pouch

Objective: This study compared the clinical efficacy of gastrointestinal anastomosis(GIA)stapler and traditional manual suture in the construction of Mainz II pouch type urinary reservoir after radical cystectomy to evaluate the safety and feasibility of gastrointestinal anastomosis(GIA)stapler in radical cystectomy.Methods: The case data of patients who underwent the Mainz II pouch procedure after radical cystectomy at the Department of Urology,the Second Hospital of Lanzhou University from January 2014 to June 2018 were reviewed.The patients were divided into two groups according to the construction method of urinary reservoir:gastrointestinal anastomosis(GIA)stapler group and traditional manual suture group.Among them,46 patients had a gastrointestinal anastomosis(GIA)stapler group(group A)and 34 patients had a traditional manual suture group(group B).The general clinical data and surgery-related clinical indicators of patients were reviewed through the hospital case system,and postoperative complications and postoperative quality of life data were collected through telephone follow-up.The data obtained were sorted out using statistical correlation methods,and the operation time,intraoperative urinary bladder construction time,intraoperative blood loss,blood transfusion requirements,postoperative ventilation time,postoperative pelvic drainage tube removal time,postoperative hospital stay,postoperative urination frequency,total hospitalization cost and postoperative complications were observed and compared between the two groups.Results: There was no significant difference in general clinical data and postoperative pathological stage and grade between the two groups(p > 0.05),indicating that there was no difference in baseline data between the two groups,with clinical comparability;the total operation time(6.8h vs 7.7h),intraoperative urinary reservoir construction time(24.4m vs 74.0m),intraoperative blood loss(399.1ml vs 655.9),number of blood transfusions(5vs10),postoperative pelvic drainage removal time(11.76 d vs 14.18d),postoperative hospital stay(17.6d vs 20.7d),postoperative daytime(8.11vs6.06)and nighttime(3.80vs3.65)voiding frequency were significantly different between the two groups(p < 0.05);however,there was no significant difference in postoperative ventilation time,total hospitalization cost and postoperative complications between the two groups(p > 0.05).Conclusion: The use of gastrointestinal anastomosis(GIA)stapler anastomosis to construct a new pouch in urinary diversion after radical resection of bladder cancer can significantly shorten the total operation time,reduce intraoperative blood loss and intraoperative and postoperative blood transfusion requirements,and reduce the average postoperative hospital stay without increasing surgery and postoperative complications.In general,gastrointestinal anastomosis(GIA)stapler is a safe and feasible new technology for the construction of new pouch;the relatively high cost of surgical consumables such as gastrointestinal anastomosis(GIA)stapler does not increase the total cost of hospitalization due to its advantages in intraoperative and postoperative effects;however,the increase in the number of micturitions during the day and night after surgery in the gastrointestinal anastomosis(GIA)stapler group,which in turn brings inconvenience to the patients’ lives,should also attract the attention of the surgeon,patients and their families.