Comparison of the urethrovesical anastomoses with polyglecaprone (Monocryl?) and bidirectional barbed (V-Loc 180?) running sutures in laparoscopic radical prostatectomy

摘要

Objective: We compared polyglecaprone (Monocryl?) and bidirectional barbed (V-Loc? 180) running sutures during urethrovesial anastomosis (UVA) in laparoscopic radical prostatectomy (LRP). Materials and methods: A total of 92 consecutive patients underwent extraperitoneal LRP for prostate cancer. In the first 47 patients, the running UVA was performed using 3-0 monofilament polyglecaprone (Monocryl?) suture (Group 1). In the subsequent 45 patients, the running UVA was performed with the 3-0 barbed suture (V-Loc? 180) (Group 2). Rhabdosphincter reconstruction was performed in all the patients. Results: The mean prostatectomy time was 196 and 179 minutes in Group 1 and 2, respectively (p < 0.001). Moreover, the mean UVA time was 40 and 24 minutes in Group 1 and 2, respectively (p < 0.001). Also, catheterization time, lenght of hospital stay and the number of the patients with urine leakage were significantly lower in Group 2 than the other (p < 0.001). No patients in V-Loc? 180 suture group and 5 patients in Monocryl? suture group experienced postoperative drain leakage in the present study. Overall pad usage at 6th month was higher in group 1 than the other group. In group 1 and 2, 78.7% and 93.3% of the patients reported 0 to 1 pads daily, whereas 21.3% and 6.7% reported ≥ 2 pads daily (p = 0.002). Conclusions: We therefore consider that use of barbed suture running UVA during LRP is associated with a significantly shorter operative time maintaining a proper suturing tension compared with standard suture and it is not associated with a higher incidence of adverse events with no postoperative complications.