Background: Pelvic lymph node dissection (PLND) is recommended while performing robot-assisted radical prostatectomy (RARP) for patients with localized intermediate or high-risk prostate cancer. However, symptomatic lymphoceles can occur after surgery, adding significant morbidity to patients. Our objective is to describe a novel Peritoneal Bladder Flap Bunching technique (PBFB) to reduce the risk of clinically significant lymphoceles in patients undergoing RARP and PLND. Methods: We evaluated 2267 patients who underwent RARP with PLND, dividing them into two groups: Group 1, comprising 567 patients who had the peritoneal flap (PBFB), and Group 2, comprising 1700 patients without the flap; propensity score matching carried out at a 1:3 ratio. Variables analyzed included estimated blood loss (EBL), operative time, postoperative complications, lymphocele formation, and the development of symptomatic lymphocele. Results: The two groups exhibited similar preoperative characteristics after matching. There was no statistically significant difference in the occurrence of lymphoceles between the flap group and the non-flap group, with rates of 24% and 20.9%, respectively (p= 0.14). However, none of the patients in the flap group (0%) developed symptomatic lymphoceles, whereas 2.2% of patients in the non-flap group experienced symptomatic lymphoceles (p= 0.01). Conclusion: We have demonstrated a modified technique for a peritoneal flap (PBFB) with the initial elimination of postoperative symptomatic lymphoceles and promising short-term outcomes.
背景：对于局限性中危或高危前列腺癌患者，在实施机器人辅助根治性前列腺切除术（RARP）时，建议同时进行盆腔淋巴结清扫术（PLND）。然而，术后可能出现症状性淋巴囊肿，显著增加患者并发症风险。本研究旨在描述一种新型腹膜膀胱瓣束扎技术（PBFB），以降低接受RARP及PLND患者发生临床显著性淋巴囊肿的风险。方法：我们评估了2267例接受RARP联合PLND的患者，将其分为两组：第一组567例患者采用腹膜瓣技术（PBFB），第二组1700例患者未采用该技术；通过倾向评分匹配按1:3比例进行分组。分析变量包括估计失血量（EBL）、手术时间、术后并发症、淋巴囊肿形成及症状性淋巴囊肿发生情况。结果：匹配后两组患者术前特征相似。腹膜瓣组与非腹膜瓣组的淋巴囊肿总发生率分别为24%和20.9%，无统计学显著差异（p=0.14）。然而，腹膜瓣组患者无一例（0%）发生症状性淋巴囊肿，而非腹膜瓣组症状性淋巴囊肿发生率为2.2%（p=0.01）。结论：本研究展示的改良腹膜瓣技术（PBFB）能完全消除术后症状性淋巴囊肿，短期疗效显著。
肿瘤(癌症)患者之家