摘要
目的探讨腹腔镜根治术对转移性前列腺癌的安全性和疗效。方法对14例确诊骨转移或淋巴结转移的前列腺癌患者实施腹腔镜前列腺癌根治术,观察围术期指标、术后近期并发症、切缘情况、术后前列腺特异抗原(PSA)水平变化及转移灶变化等指标。结果 14例患者均顺利完成腹腔镜根治术,手术时间平均在170min,出血量平均为400mL,直肠损伤7%(1/14),无膀胱输尿管损伤,术后平均住院日为8d,切缘阳性率57%(8/14),严重尿漏7%(1/14),淋巴漏50%(7/14)。术后随访6个月,1个月尿失禁发生率80%,3个月为50%,6个月为0%。术后3月内无内分泌治疗的情况下,PSA水平均较术前降低。结论腹腔镜前列腺根治术切除前列腺原发灶对伴有远处转移的患者是安全可行的,这需要由丰富腔镜经验的泌尿外科医生操作,并且术前需要对手术患者进行充分的筛选。术后近期PSA水平均有不同程度下降。
Objective To investigate the safety and efficacy of radical prostatectomy of metastatic prostate cancer. Methods Radical laparoscopic prostatectomy was performed in 14 confirmed cases of prostate cancer with bone metastasis or lymph node metastasis. The perioperative outcomes, short-term complications, margin status, postoperative changes of PSA level and metastasis were recorded. Results All operations were successful. The mean operation time was 170 min, hemorrhage volume averaged 400 mL, postoperative average hospitalization was 8 days, and positive margin rate was 57 % （8/14）. The incidence of rectal injury, severe anastomotic leak and lymph leak was 7% （1/14）, 7% （1/14） and 50% （7/14）. The incidence of urinary incontinence was 80 %, 50 %, and 0 % 1 month, 3 months and 6 months after surgery. With no hormone deprivation therapy within 3 months, the level of PSA was lower than that before operation. Conclusion Laparoscopic radical prostatectomy is safe and feasible for patients with distant metastasis, which requires experienced urologic surgeons and adequate screening of suitable patients. Postoperative short-term PSA levels decrease in different degrees.
出处
《现代泌尿外科杂志》
CAS
2016年第10期772-775,共4页
Journal of Modern Urology
关键词
转移性前列腺癌
前列腺根治术
腹腔镜
metastatic prostate cancer
radical prostatectomy
laparoscopy
