前列腺癌根治术中直肠损伤的处理经验总结与文献回顾

打开文本图片集

ABSTRACT：ObjectiveTo summarize the clinical characteristics，diagnosis，treatment and outcomes of rectal injury（RI） occurringafterradical prostatectomy（RP）.MethodsTheclinical dataof 513 patients with prostaticcancer undergoing RPin ourhospitalduring Mar.2Ol3andOct.2022 wereretrospectivelycollected and statisticaldescriptionof theocurenceofRI among them was conducted.There wereatotalof7patients with RIduring operationandl progresed torectourethralfistula （RUF）.We summarized theclinical and pathologicaldataof these7patients.The treatment strategiesof RI/RUFafter RPin 11 diferent centers were exploredand summarized incombination with literature review.ResultsAmong the7RIpatients， 6 developed RI during operationand healed afterrepair，while1 progressd to RUF after operation.For this patient， conservative treatmentfailed and colostomy was performed along with bilateral ureteralstent placementand cystostomy.The RUFwas repairedvia the transanal approach.During the treatment process，recurrentandrefractorybladderirritation symptoms and bladder spasms occurred.Dataof 32O3patients whounderwentRPin1l diferentcenters werecollected; 56（1.75% ） cases developed RI，4l of which were detected and repaired during operation; 14（0.44% ） developed RUF，7 of which had fistula closed spontaneouslyand7received surgicalrepair.ConclusionRI，especiallyRUF，isoneof therarestand severest complicationsafterRP.Once RIisdetected during operation，immediate andthorough two-layer suturerepairshould be performed.

KEY WORDS ： prostatic cancer； radical prostatectomy； rectal injury；rectourethral fistula

摘要：目的总结前列腺癌根治术（RP）中发生直肠损伤（RI）的临床特征、诊治经过及治疗效果。（剩余8186字）