经会阴穿刺注射玻璃酸钠扩张狄氏间隙改良前列腺根治性切除术安全性的动物实验

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Safety of modified radical prostatectomy by transperineal injection of sodium hyaluronate to the Dirichlet gap：an animal  experiment

WU Jinbang1，ZHU Bo1，CHEN Weidong1，CHEN Fei1，FAN Chunhong1，YU Tingting1，DONG Taotao2，3，LIU Xun2，3，WANG Yunhan2，WANG Zili2

（1.Department of Urology，Deyang Fifth Hospital，Deyang 618099;2.Department of Urology，Affiliated Hospital of Chengdu University，Chengdu 610081；3.Central Laboratory，Affiliated Hospital of Chengdu University，Chengdu 610081，China）

ABSTRACT：ObjectiveTo explore the safety of transrectal ultrasound，guided transperineal injection of sodium hyaluronate to expand the Dirichlet gap in laparoscopic radical prostatectomy.MethodsA total of 14 healthy male purebred beagle dogs were selected and randomly divided into 2 groups，with 7 in either group.The control group was treated with conventional laparoscopic radical prostatectomy，while the experimental group was treated with laparoscopic radical prostatectomy after 2.5 mL sodium hyaluronate was injected into the Dirichlet gap under the guidance of transrectal ultrasound.The total operation time，prostate separation time，intraoperative blood loss and rectal status of the 2 groups were observed.ResultsAfter the injection of sodium hyaluronate into the Dirichlet gap between the prostate and the rectum，no rectal tissue was found in the prostate，and no obvious damage was found in the posterior rectum in either groups.The postoperative hemoglobin （HGB） was [（118.70±2.56） g/L vs.（122.10±2.19） g/L，P=0.02]；the total operation time was [（141.40±9.80） min vs.（119.10±916） min，P<0.05]；the prostate separation time was [（24.99±1.75） min vs.（16.64±2.34） min，P<0.05]；the amount of bleeding was [（47.43±4.32） mL vs.（34.86±5.18） mL，P<0.05] in the control group and experimental group.Conclusion Laparoscopic radical prostatectomy performed after 2.5 mL of sodium hyaluronate injection into the Dirichlet gap under the guidance of transrectal ultrasound can shorten the total operation time，the separation and resection time of the prostate，and reduce the amount of bleeding，which can improve and reduce the incidence of rectal injury，and prove the feasibility of this approach for prostatic cancer.

KEY WORDS：prostate cancer；rectal injury；Dirichlet gap；sodium hyaluronate；laparoscope；animal experiment；radical prostatectomy；safety of surgery

摘要：目的通过动物实验组织学观察，探讨经直肠超声引导下经会阴穿刺注射玻璃酸钠扩张狄氏间隙在提升腹腔镜下前列腺根治性切除术安全性方面的价值。（剩余8247字）