Running suture versus interrupted suture for vesicourethral anastomosis in retropubic radical prostatectomy: A randomized study
2015
Objectives To determine the feasibility of vesicourethral
anastomosisusing running suture during retropubic radical
prostatectomyand to compare the surgical outcomes of vesicourethral
anastomosisusing running suture with those of the standard interrupted suture technique. Methods A total of 60 patients undergoing radical
prostatectomyfrom 2010 to 2012 at the Yamaguchi University Hospital, Japan were included in the present study, and were randomly assigned to vesicourethral
anastomosisusing running suture (n = 30 patients) or a standard interrupted suture technique group (n = 30 patients). Vesicourethral
anastomosisusing running suture was carried out with 12-bite sutures using 3-0 poliglecaprone. The primary end-point was the time to catheter removal. Patients' health-related quality of life was assessed using the Expanded Prostate Cancer Index Composite in 56 patients (28 patients in each group). Results No significant difference was found in the median suturing time between the two study groups (both 19 min, P = 0.449). The time to catheter removal was significantly better in the vesicourethral
anastomosisusing running suture group (hazard ratio 5.23, 95% confidence interval 1.73–17.65, P = 0.003). The pad-free rate was significantly higher in the vesicourethral
anastomosisusing running suture group at 1 month after surgery (20.7% vs 3.3%, P = 0.0463); however, there was no significant difference at 3 months and beyond. The Expanded Prostate Cancer Index Composite urinary and bowel summary scores at 1 month were significantly better in the vesicourethral
anastomosisusing running suture patients (both P < 0.01), though no significant difference was observed thereafter. A vesicourethral
anastomosisstricture was noted in three patients (10%) in the standard interrupted suture technique group, and none in the vesicourethral
anastomosisusing running suture group. Conclusion Running suture for vesicourethral
anastomosisis feasible during retropubic radical
prostatectomy. Furthermore, it offers better outcomes than the conventional standard interrupted suture technique, with a higher likelihood of improvement in patients' health-related quality of life.
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