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根治性前列腺切除术

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ID: ANCE00192chis
医学动画文字记录:前列腺是一个核桃大小的腺体。它位于膀胱的底部,包裹着尿道。前列腺癌是男性最常见的癌症类型之一。根治性前列腺切除术是一种切除前列腺、周围组织和精囊的外科手术。根据病情,医生也可以选择切除一些淋巴结。在手术前,先建立静脉通路。可能会通过静脉注射抗生素来减少感染的机会。可能会采取全身麻醉、脊髓或硬膜外麻醉。如果采取全身麻醉,经口腔进行气管插管达到喉以下,以帮助你在术中呼吸。如果采取脊髓或硬膜外麻醉,就不需要插管了。医生会给你打镇定剂帮助你放松。根治性前列腺切除术需要90分钟到4小时。三种不同的方法可以选择:经耻骨后开放性手术、经会阴开放性手术或腹腔镜手术。在经耻骨后开放性前列腺切除术中,前列腺是通过腹部下端的切口切除的。在经会阴开放性前列腺切除术中,前列腺通过会阴的一个切口切除,这个切口位于直肠和阴囊之间。在腹腔镜前列腺切除术中,医生通过小的锁孔切口或孔将器械放入腹腔。医生将前列腺从周围的结构中分离,并通过稍宽的孔移除腺体。根据癌症是否已经扩散,医生也可能切除前列腺周围的组织,包括精囊和淋巴结。无论哪种手术,在切除任何组织之前,医生都会仔细检查前列腺周围的区域,注意尽量减少对该区域神经的损伤。手术结束时,在膀胱中放置导尿管以保持膀胱排空。通常在手术后保留10天到2周。手术后不久,即可拔除气管插管,你将被带到恢复区进行监测,并根据需要给你止痛药。可能会继续通过静脉注射抗生素,并用无菌溶液间歇地通过导管冲洗出积聚的血液和凝块。大多数病人在手术后两天就可以出院了。

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