【摘要】 目的:评估背深静脉复合体(DVC)免缝扎技术在机器人辅助腹腔镜根治性前列腺切除术中的应用。方法:本研究选取2021年1月至2024年1月在浙江省人民医院接受机器人辅助腹腔镜前列腺癌根治术的114例前列腺癌患者，分为对照组(57例)和观察组(57例)。对照组采用传统“8”字形缝扎法处理DVC,而观察组则通过提高气腹压后使用单极电凝剪直接切断DVC。记录手术时间、术中出血量、手术切缘阳性率、前列腺尖部切缘阳性率，并比较两组术后1、3、6个月时的控尿率和晨勃恢复率，通过国际勃起功能指数-5(IIEF-5)和早泄诊断量表(PEDT)评估患者术前和术后6个月的性功能。结果:观察组手术时间[(115.71±19.42)min]比对照组增加[(103.42±12.78)min,P<0.05],但两组术中出血量、手术切缘阳性率、前列腺尖部切缘阳性率相比，差异无统计学意义(P>0.05);观察组术后3个月和6个月时的控尿率和晨勃恢复率均高于对照组，且观察组术后6个月的IIEF-5评分更高，而PEDT评分低于对照组，差异均有统计学意义(P<0.05)。结论:机器人辅助腹腔镜下根治性前列腺切除术中应用DVC免缝扎技术有助于保护患者术后性功能。更多还原

【Abstract】 Objective: To evaluate the impact of sutureless approach to the dorsal venous complex(DVC) combined with robotic-assisted laparoscopic prostatectomy on sexual function of patients with prostatic cancer. Methods: This study included 114 prostate cancer patients who underwent robot-assisted laparoscopic radical prostatectomy at our hospital from January 2021 to January 2024. The patients were randomly divided into a control group(n=57) and an observation group(n=57). The control group received conventional "figure-of-eight" suture ligation of the dorsal venous complex(DVC), while the observation group underwent direct DVC transection using monopolar electrocautery scissors after increasing pneumoperitoneum pressure.Surgical duration, intraoperative blood loss, positive surgical margin rates, and positive apical margin rates were recorded. The continence rates and rates of morning erections at 1, 3 and 6 months after the operation were compared between groups. Sexual function was assessed pre-operatively and at 6 months post-operation by using the IIEF-5 and PEDT. Results: The operative time in the observation group was significantly longer than that in the control group([115.71 ± 19.42] min vs [103.42 ± 12.78] min, P<0.05). While no significant differences were observed in intraoperative blood loss, positive surgical margin rate, or positive apical margin rate between the two groups(P>0.05). At 3 and 6 months after the operation, the observation group exhibited higher urinary continence rates and morning erection recovery rates compared to the control group(P<0.05). Furthermore, at 6 months postoperatively, the observation group demonstrated significantly higher IIEF-5 scores and lower PEDT scores than those of control group(P<0.05). Conclusion: The use of a sutureless DVC technique in robotic-assisted laparoscopic radical prostatectomy protects the post-operative sexual function in patients.更多还原