Single Running Suture versus Single-Knot Running Suture for Vesicourethral Anastomosis in Laparoscopic Radical Prostatectomy: A Prospective Randomised Comparative Study

Abstract

Aim: To investigate the safety, surgical efficiency and patients' ability to recover from urinary continence as a result of a single absorbable running suture versus single-knot running suture for vesicourethral anastomosis (VUA) during laparoscopic radical prostatectomy (LRP). Material and Methods: In a prospective randomised study, we evaluated 162 consecutive patients who underwent LRP with VUA using the single running suture technique or the single-knot running suture technique. Perioperative patients' characteristics, morbidity and urinary continence were analysed. Results: The baseline characteristics were similar between the 2 groups. The single running suture technique was related to decreased anastomotic and total operative times compared with the Van Velthoven technique (13.17 ± 5.74 min vs. 28.49 ± 6.45 min, p = 0.0001, and 174.41 ± 62.97 min and 184.94 ± 46.16 min, p = 0.04, respectively). Overall, urinary continence rates at 3, 6 and 12 months in groups 1 and 2 were 49.4 and 69.1%, 81.5 and 86.4%, and 91.4 and 93.8%, respectively (all with p > 0.05 except the follow-up assessment at 3 months following surgery, p = 0.011). Conclusions: Both methods ensure satisfactory rates of urinary leakage and bladder neck stricture, as well as continence after LRP. However, since the single running suture VUA technique is easier to perform, and the mean anastomosis time of the single running suture VUA technique is shorter than that of the Van Velthoven technique, it appears, therefore, preferable.

Impact of Altered WNT2B Expression on Bladder Wall Fibroblasts: Implications for Apoptosis Regulation in the Stroma of the Lower Urinary Tract

“…In VUAS, such biomarkers could complement existing clinical risk factors like the extent of apical resection, the type of anastomosis suture and excessive perioperative blood loss during RP or post-operative infection and leakage at the anastomosis site [34-36]. Furthermore, WNT pathway alterations could also have implications for targetted therapies of fibrotic diseases of the urinay tract [22].…”

Van Velthoven single-knot running suture versus Chlosta’s running suture versus single barbed suture V-Loc for vesicourethral anastomosis in laparoscopic radical prostatectomy: a retrospective comparative study

“…Many VUA methods during LRP aim to simplify the surgical procedure and reduce the time of surgery [9][10][11][12][13][14][15][16]. In 2009, an alternative technique for laparoscopic running VUA, Chlosta's running suture, was described [17,18]. The aim of the current study was to compare complication rates and urinary function outcomes of patients who underwent LRP in terms of the VUA suturing technique in a single tertiary care center in Poland.…”

Análisis comparativo y evolutivo de la prostatectomía radical en la última década. Impacto de la implantación de la cirugía robótica en un único centro español

“…La PRL y la PRLAR ofrecen más posibilidades (puntos interrumpidos vs. continuos; sutura barbada vs. monofilamento; ...). Aun así, no se han observado diferencias en las tasas de IU o estenosis de la anastomosis entre las distintas técnicas, pero el tiempo de anastomosis es menor cuando se emplea una única sutura barbada continua [115]- [117].…”