經(jīng)會陰穿刺注射玻璃酸鈉擴(kuò)張狄氏間隙改良前列腺根治性切除術(shù)安全性的動物實(shí)驗(yàn)

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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，F(xiàn)AN 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：目的通過動物實(shí)驗(yàn)組織學(xué)觀察，探討經(jīng)直腸超聲引導(dǎo)下經(jīng)會陰穿刺注射玻璃酸鈉擴(kuò)張狄氏間隙在提升腹腔鏡下前列腺根治性切除術(shù)安全性方面的價(jià)值。（剩余8247字）