论文部分内容阅读
探讨TURP术后偶发前列腺癌行开放及腹腔镜前列腺癌根治术的手术技巧及经验,并比较其优劣。方法:回顾性分析2007年1月～2012年4月两个中心收治的TURP术后病检所发现的偶发前列腺癌患者9例,TURP术后平均(12.0±3.6)周行前列腺癌根治术,其中开放和腹腔镜下前列腺癌根治术分别为5例和4例。结果:患者平均年龄67岁,9例手术顺利完成,全部经腹途径进行手术。开放手术组平均手术时间(220.1±40.2)min,术中平均出血(212.5±110.6)ml;腹腔镜组平均手术时间(321.3±68.7)min,术中平均出血(110.2±51.7)ml,术后平均随访(18.4±10.4)个月,最长30个月,9例均存活,8例控尿功能好,无明显尿失禁,1例站立位时尿失禁。9例患者监测PSA均小于0.2μg/L。结论:TURP术后行前列腺癌根治术对于偶发前列腺癌疗效满意,先前的TURP术增加了手术操作难度,应结合解剖结构改变采取相应的手术策略。与开放手术相比,腹腔镜手术具有解剖清楚、失血量少、术后尿控好的优点。
To explore the surgical techniques and experience of open prostatectomy and laparoscopic radical prostatectomy after TURP and to compare the advantages and disadvantages. Methods: Nine patients with recurrent prostate cancer who were diagnosed by TURP postoperatively from January 2007 to April 2012 were retrospectively analyzed. Radical prostatectomy was performed on average (12.0 ± 3.6) weeks after TURP. Including open and laparoscopic radical prostatectomy were 5 cases and 4 cases. Results: The average age of patients was 67 years old, 9 cases were successfully completed and all were operated on by abdominal approach. The mean operative time was (220.1 ± 40.2) min in open surgery group, mean intraoperative bleeding was (212.5 ± 110.6) ml in laparoscopic group, mean operative time in laparoscopic group (321.3 ± 68.7) min and mean intraoperative bleeding was (110.2 ± 51.7) All patients were followed up for an average of (18.4 ± 10.4) months, up to 30 months. Nine patients survived. Eight patients had good urinary control and no urinary incontinence. One patient had standing incontinence. Nine patients with PSA were less than 0.2μg / L. Conclusion: TURP radical prostatectomy is effective in the treatment of recurrent prostate cancer. The previous TURP technique increased the difficulty of surgical operation and should be combined with anatomic changes to take corresponding surgical strategies. Compared with open surgery, laparoscopic surgery with anatomical clear, less blood loss, postoperative urinary control advantages.