Влияние вариантов реконструкции уретровезикального анастомоза при выполнении радикальной простатэктомии на восстановление функции удержания мочи

Голубцова Е.Н., Томилов А.А., Велиев Е.И. Влияние вариантов реконструкции уретровезикального анастомоза при выполнении радикальной простатэктомии на восстановление функции удержания мочи. Consilium Medicum. 2018; 20 (7): 26–29. DOI: 10.26442/2075-1753_2018.7.26-29

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Golubtsova E.N., Tomilov A.A., Veliev E.I. Influence of urethrovesical anastomosis reconstruction variants use in radical prostatectomy on urinary continence recovery. Consilium Medicum. 2018; 20 (7): 26–29. DOI: 10.26442/2075-1753_2018.7.26-29

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Аннотация

Применение радикальной простатэктомии как основного метода хирургического лечения пациентов, страдающих раком предстательной железы, позволило достичь удовлетворительных онкологических результатов. В настоящее время научно-исследовательские работы сфокусированы на оценке функциональных результатов и их улучшении. Все большее значение приобретает вопрос скорейшего восстановления континенции в ранние сроки после операции. Робот-ассистированная радикальная простатэктомия демонстрирует определенные преимущества в сохранении анатомии малого таза и сфинктерного аппарата. На сегодняшний день дискутабельным предметом является использование различных техник реконструкции зоны уретровезикального анастомоза и сохранения сосудисто-нервных пучков. Различают варианты реконструкции передней, задней полуокружности уретровезикального анастомоза и тотальную. В ряде случаев методики дополняют друг друга. Накопление знаний и опыта поможет выбрать оптимальную методику и, возможно, стандартизировать технику операции с целью улучшения функциональных результатов и качества жизни пациентов.

Ключевые слова: простатэктомия, уретровезикальный анастомоз, реконструкция.

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The use of radical prostatectomy as the main surgical treatment method in patients with prostate cancer allowed to achieve satisfying results. At present time scientific research is focused on functional results evaluation and improvement. The question of early continence recovery in the early stages after operation has become increasingly important. Robot-assisted radical prostatectomy demonstrates several advantages in small pelvis anatomy and sphincters preservation. At present the use of various techniques for urethrovesical anastomosis reconstruction and neurovascular tracts preservation is discussed. There are possibilities of front and back semi-circle of urethrovesical anastomosis reconstruction and total reconstruction. In some instances these methods complement one another. Knowledge and experience accumulation will allow to choose the optimal method and probably to standardize the operation technique in order to improve functional results and patients' quality of life.

Key words: prostatectomy, urethrovesical anastomosis, reconstruction.

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Список литературы

2. Cooperberg MR, Carroll PR. Trends in management for patients with localized prostate cancer, 1990–2013. JAMA 2015; 314: 80–2.
3. Sukumar S, Rogers CG, Trinh QD et al. Oncological outcomes after robot-assisted radical prostatectomy: long-term follow-up in 4803 patients. BJU Int 2014; 114: 824–31.
4. Ficarra V, Novara G, Rosen RC et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol 2012; 62: 405–17.
5. Noguchi M, Kakuma Т, Suekane S еt al. A randomized clinical trial of suspension technique for improving early recovery of urinary continence after radical retropubic prostatectomy. BJU Int 2008; 102: 958–63.
6. Patel VR, Coelho RF, Palmer KJ et al. Periurethral suspension stitch during robot-assisted laparoscopic radical prostatectomy: description of the technique and continence outcomes. Eur Urol 2009; 56: 472–8.
7. Bahler CD, Sundaram CP, Kella N et al. A parallel randomized clinical trial examining the return of urinary continence after robotassisted radical prostatectomy with or without a small intestinal submucosa bladder neck sling. J Urol 2016; 196: 179–84.
8. Cestari A, Ferrari M, Ghezzi M et al. Retropubic intracorporeal placement of a suburethral autologous sling during robot-assisted radical prostatectomy to improve early urinary continence recovery: preliminary data. J Endourol 2015; 29: 1379–85.
9. Walz J, Burnett AL, Costello AJ et al. A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy. Eur Urol 2010; 57: 179–92.
10. Costello AJ, Dowdle BW, Namdarian B et al. Immunohistochemical study of the cavernous nerves in the periprostatic region. Bju Int 2010; 107, 1210–5.
11. Tewari AK, Ali A, Ghareeb G et al. Improving time to continence after robot-assisted laparoscopic prostatectomy:augmentation of the total anatomic reconstruction technique by adding dynamic detrusor cuff trigonoplasty and suprapubic tube placement. J Endourol 2012; 26: 1546–52.
12. Lim SK, Kim KH, Shin TY et al. Current status of robot-assisted laparoscopic radical prostatectomy: how does it compare with other surgical approaches? Int J Urol 2013; 20: 271–84.
13. Galfano A, Trapani D, Sozzi F et al. Beyond the learning curve of the retzius-sparing approach for robot-assisted laparoscopic radical prostatectomy: oncologic and functional results of the first 200 patients with ≥1 year of follow-up. Eur Urol 2013; 64: 974–80.
14. Lim SK, Kim KH, Shin TY et al. Retzius-sparing robot-assisted laparoscopic radical prostatectomy: combining the best of retropubic and perineal approaches. BJU Int 2014; 114 (2): 236–44.
15. Rocco B, Cozzi G, Spinelli MG et al. Posterior musculofascial reconstruction after radical prostatectomy: a systematic review of the literature. Eur Urol 2012; 62: 779–90.
16. Ghani KR, Menon M. Posterior reconstruction: weighing the evidence. Eur Urol 2012; 62: 791–3.
17. Jeong W, Lee JK, Oh JJ et al. Effects of New 1-Step Posterior Reconstruction Method on Recovery of Continence after Robot-Assisted Laparoscopic Prostatectomy: Results of a Prospective, Single-Blind, Parallel Group, Randomized, Controlled Trial Chang. J Urol 2015; 193 (3): 935–42.
18. Student VJr, Vidlar A, Grepl M et al. Advanced Reconstruction of Vesicourethral Support (ARVUS) during Robot-assisted Radical Prostatectomy: One-year Functional Outcomes in a Two-group Randomised Controlled Trial. Eur Urol 2017; 71 (5): 822–30.
19. Gratzke C, Dovey Z, Novara G et al. Early Catheter Removal after Robot-assisted Radical Prostatectomy: Surgical Technique and Outcomes for the Aalst Technique (ECaRemA Study). Eur Urol 2016; 69 (5): 917–23.
20. Porpiglia F, Bertolo R, Manfredi M et al. Total Anatomical Reconstruction During Robot-assisted Radical Prostatectomy: Implications on Early Recovery of Urinary Continence. Eur Urol 2016; 69 (3): 485–95.

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1. Abdollah F, Sood A, Sammon JD et al. Long-term cancer control outcomes in patients with clinically high-risk prostate cancer treated with robot-assisted radical prostatectomy: results from a multi-institutional study of 1100 patients. Eur Urol 2015; 68: 497–505.
2. Cooperberg MR, Carroll PR. Trends in management for patients with localized prostate cancer, 1990–2013. JAMA 2015; 314: 80–2.
3. Sukumar S, Rogers CG, Trinh QD et al. Oncological outcomes after robot-assisted radical prostatectomy: long-term follow-up in 4803 patients. BJU Int 2014; 114: 824–31.
4. Ficarra V, Novara G, Rosen RC et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol 2012; 62: 405–17.
5. Noguchi M, Kakuma Т, Suekane S еt al. A randomized clinical trial of suspension technique for improving early recovery of urinary continence after radical retropubic prostatectomy. BJU Int 2008; 102: 958–63.
6. Patel VR, Coelho RF, Palmer KJ et al. Periurethral suspension stitch during robot-assisted laparoscopic radical prostatectomy: description of the technique and continence outcomes. Eur Urol 2009; 56: 472–8.
7. Bahler CD, Sundaram CP, Kella N et al. A parallel randomized clinical trial examining the return of urinary continence after robotassisted radical prostatectomy with or without a small intestinal submucosa bladder neck sling. J Urol 2016; 196: 179–84.
8. Cestari A, Ferrari M, Ghezzi M et al. Retropubic intracorporeal placement of a suburethral autologous sling during robot-assisted radical prostatectomy to improve early urinary continence recovery: preliminary data. J Endourol 2015; 29: 1379–85.
9. Walz J, Burnett AL, Costello AJ et al. A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy. Eur Urol 2010; 57: 179–92.
10. Costello AJ, Dowdle BW, Namdarian B et al. Immunohistochemical study of the cavernous nerves in the periprostatic region. Bju Int 2010; 107, 1210–5.
11. Tewari AK, Ali A, Ghareeb G et al. Improving time to continence after robot-assisted laparoscopic prostatectomy:augmentation of the total anatomic reconstruction technique by adding dynamic detrusor cuff trigonoplasty and suprapubic tube placement. J Endourol 2012; 26: 1546–52.
12. Lim SK, Kim KH, Shin TY et al. Current status of robot-assisted laparoscopic radical prostatectomy: how does it compare with other surgical approaches? Int J Urol 2013; 20: 271–84.
13. Galfano A, Trapani D, Sozzi F et al. Beyond the learning curve of the retzius-sparing approach for robot-assisted laparoscopic radical prostatectomy: oncologic and functional results of the first 200 patients with ≥1 year of follow-up. Eur Urol 2013; 64: 974–80.
14. Lim SK, Kim KH, Shin TY et al. Retzius-sparing robot-assisted laparoscopic radical prostatectomy: combining the best of retropubic and perineal approaches. BJU Int 2014; 114 (2): 236–44.
15. Rocco B, Cozzi G, Spinelli MG et al. Posterior musculofascial reconstruction after radical prostatectomy: a systematic review of the literature. Eur Urol 2012; 62: 779–90.
16. Ghani KR, Menon M. Posterior reconstruction: weighing the evidence. Eur Urol 2012; 62: 791–3.
17. Jeong W, Lee JK, Oh JJ et al. Effects of New 1-Step Posterior Reconstruction Method on Recovery of Continence after Robot-Assisted Laparoscopic Prostatectomy: Results of a Prospective, Single-Blind, Parallel Group, Randomized, Controlled Trial Chang. J Urol 2015; 193 (3): 935–42.
18. Student VJr, Vidlar A, Grepl M et al. Advanced Reconstruction of Vesicourethral Support (ARVUS) during Robot-assisted Radical Prostatectomy: One-year Functional Outcomes in a Two-group Randomised Controlled Trial. Eur Urol 2017; 71 (5): 822–30.
19. Gratzke C, Dovey Z, Novara G et al. Early Catheter Removal after Robot-assisted Radical Prostatectomy: Surgical Technique and Outcomes for the Aalst Technique (ECaRemA Study). Eur Urol 2016; 69 (5): 917–23.
20. Porpiglia F, Bertolo R, Manfredi M et al. Total Anatomical Reconstruction During Robot-assisted Radical Prostatectomy: Implications on Early Recovery of Urinary Continence. Eur Urol 2016; 69 (3): 485–95.

Авторы

Е.Н.Голубцова*1,2, А.А.Томилов2, Е.И.Велиев1,2

1 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России. 125993, Россия, Москва, ул. Баррикадная, д. 2/1;

2 ГБУЗ «Городская клиническая больница им. С.П.Боткина» Департамента здравоохранения города Москвы. 125284, Россия, Москва, 2-й Боткинский пр-д, д. 5
*engolubtsova@yandex.ru

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E.N.Golubtsova*1,2, A.A.Tomilov2, E.I.Veliev1,2

1 Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation. 125993, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1;
2 S.P.Botkin City Сlinical Hospital of the Department of Health of Moscow. 125284, Russian Federation, Moscow, 2-i Botkinskii pr-d, d. 5
*engolubtsova@yandex.ru

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