Control Of Prostatic Apex During Laparoscopic Radical Prostatectomy And Anatomical And Histological Study Of Prostatic Apex

BackgroundProstate cancer is one of the most common urological tumors in China,In recent years,the incidence of prostate cancer has increased year by year,and its growth rate is the first in male tumors,which has become another threat to the health of men in China.There are many treatments for prostate cancer,but one of the most effective methods is radical prostatectomy.In China,laparoscopic radical prostatectomy has made prostate resection more minimally invasive and more sophisticated.Although some large medical centers in China carry out Robot-assisted laparoscopic prostatectomy,But for the majority of primary hospitals,laparoscopic radical prostatectomy is still a more economical and practical technique.The management of the apex of prostate is one of the key steps in laparoscopic radical prostatectomy,which is closely related to intraoperative bleeding,positive rate of incision margin and postoperative urinary control.It is very important for urologists to understand the anatomical structure of the apex of the prostate,to deal with the apex of the prostate and to shorten the learning curve.Therefore,this study will introduce a laparoscopic radical prostatectomy of prostate apex management and anatomical and histological characteristics,ObjectiveTo understand the anatomical,histological and surgical features of the apex of the prostate.MethodsUnder the guidance of my master's supervisor,we reviewed the relevant literature,summarized and analyzed the anatomical and histological features of the apex of the prostate,and combined with the anatomy of the apex of the prostate.The histological features of 21 cases of laparoscopic radical prostatectomy with complete data from August 2015 to February 2018 were analyzed.To summarize the technical points of management of the apex of prostate in laparoscopic radical prostatectomy.Results(1)VPM was located at the posterior side of the bladder neck between the bladder wall and seminal vesicle prostate in 17/21 cases.Four out of 21 cases of VPM could not be separated from the whole group of 21 cases of Laparoscopic Prostate Cancer radical mastectomy.(2)Detrusor apron(DA)can be found in prostatic preprostatic manifestations in 21 cases of laparoscopic radical prostatectomy and 21 cases without vascularization can be treated with Dorsal vascular complex(DVC)without suture.(3)17/21 cases of urethral prostatic gland with proper length can be separated from the tip of the prostate by pulling and rotating.Four out of 21 cases can pull out the wall of the urethra,complete urethra,and 21 cases of the prostatic gland with incomplete urethral wall pulling out part of the tube wall.(4)Postoperative urethrography showed that the average length of functional urethra was 1.53±0.55cm.ConclusionDuring laparoscopic radical prostatectomy for prostate cancer,a certain length of urethral prostatic gland can be anatomically separated,and Dorsal vascular.complex(D VC)can be treated without sutured,so that the anastomosis of bladder neck and posterior urethra can be realized by urethral and urethral anastomosis.It has certain significance for short-term urinary control after laparoscopic radical.prostatectomy,which can be used for reference.