AB086. Comparison of two kinds of methods for urethrovesical anastomosis during laparoscopic radical prostatectomy

Abstract

ObjectiveTo compare two kinds of running sutures for urethrovesical anastomosis (UVA) during laparoscopic radical prostatectomy (LRP).Materials and MethodsFrom January 2014 to June 2015, 32 consecutive patients underwent extraperitoneal LRP for prostate cancer by two experienced surgeons. In group 1 (n=15), the UVA was performed by one surgeon using single needle bi-directional traction running suture with 5/8 circle 3-0 Monocryl®. The suture was initiated clockwise from 5-o’clock and the end was out of body from trocar to keep constant tension. After stitch completing, the redundant tail was cut and the suture was tightened through bi-directional traction and tied with the tail on 5-o’clock finally. In group 2 (n=17), the UVA was performed by another surgeon using single needle barbed running suture with 5/8 circle 3-0 V-Loc®. The suture was performed by the same way as group 1 but with the end of the suture knotted on 5-o’clock. The time of UVA, removal time of drainage tube and Foley catheter, postoperative hospital stay and rate of urine leak were measured and compared. The degree of difficulty of operation was evaluated by the same first assistant.ResultsThe mean operation time was 187 and 192 minutes in groups 1 and 2, respectively (P>0.05). Moreover, the mean UVA time was 33 and 35 minutes in groups 1 and 2, respectively (P>0.05). Also, removal time of drainage tube, catheterization time, lenght of hospital stay were no significant difference between group 1 and group 2. The rate of urine leak was higher in group 1 (7/15) than group 2 (3/17), but there was no difference between two groups. The difficulty of operation evaluated by first assistant was lower in group 1 than group 2 (P<0.05).ConclusionsThe single needle bi-directional traction running suture could maintain a proper suturing tension, so it could compare with single needle barbed running suture in operation time and UVA time. Moreover, it might be a more easier method of urethrovesical anastomosis for beginner in learning curve during LRP.