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目的探讨背静脉复合体(dorsal vein complex,DVC)的解剖学形态、分支、走行、回流途径及周围组织关系,以指导膀胱癌、前列腺癌根治性切除手术中对DVC的准确处理。方法解剖6具男性成年尸体盆腔标本,记录DVC、耻骨前列腺韧带、阴茎背深静脉(deep dorsal vein,DDV)及阴部内静脉等组织结构、走行特点。结果 6具标本DVC分深、浅两层结构,浅层为前列腺浅表静脉,深层为前列腺静脉丛。前列腺浅表静脉在左右耻骨前列腺韧带之间,前列腺前面为单干,在膀胱颈处形成分支;前列腺静脉丛在前列腺筋膜深面局限于两耻骨前列腺韧带之间,平均宽度20.52mm。DVC远端与阴部内静脉、DDV及闭孔静脉存在多种形式的广泛交通,近端则分别进入两侧膀胱前列腺静脉丛,可通过阴部内静脉、闭孔静脉及膀胱前列腺静脉丛回流入髂内静脉。结论 DVC局限于前列腺前面两耻骨前列腺韧带之间。耻骨前列腺韧带前列腺附着部可作为确定DVC位置及范围的解剖标志,在耻骨前列腺韧带外侧游离前列腺可有效避免DVC损伤。DVC与阴部内静脉、DDV、膀胱前列腺静脉丛及闭孔静脉存在广泛交通。在前列腺尖部贯穿左右耻骨前列腺韧带外侧缝扎才能将DVC主干完全阻断,有效减少出血。
Objective To investigate the anatomical features, branches, sagittal and reflow pathways of dorsal vein complex (DVC) and its relationship with surrounding tissues to guide the accurate treatment of DVC in radical resection of bladder cancer and prostate cancer. Methods Pelvic specimens of 6 adult male cadavers were dissected and histological features of DVC, pubic prostate ligament, deep dorsal vein (DDV) and internal genital vein were recorded. Results Six specimens of DVC were divided into deep and shallow two-layer structure, superficial prostatic superficial veins, and deep prostatic venous plexus. Prostate superficial vein between the left and right pubic prostate ligaments, the prostate in front of a single stem, forming a branch in the bladder neck; Prostatic plexus deep in the fascia of the prostate confined between the two pubic prostate ligaments, the average width of 20.52mm. DVC distal and genitourinary vein, DDV and obturator venous there are many forms of extensive traffic, respectively, the proximal into the bilateral bladder prostatic venous plexus, through the genitourinary vein, obturator veins and bladder prostatic venous plexus back into the iliac Internal vein. Conclusions DVC is limited to the anterior prostate between the two pubic prostheses. Prostate prostatitis prostate attachment can be used as an anatomical landmark to determine the location and extent of DVC. Prostate free prostateis outside the pubiclophoric ligaments can effectively prevent DVC injury. DVC and genital internal vein, DDV, bladder Prostate venous plexus and obturator veins exist extensive traffic. In the prostatic apex through the left and right pubic prostate ligaments outside the suture can completely block the DVC trunk, effectively reduce bleeding.