和前列腺体积对于前列腺癌伴精囊腺转移的评估课件.ppt

制作：郑勇军 * * 前列腺体积和术前PSA值水平------预测前列腺癌并精囊腺转移的两项重要指标 Preoperative Prostate Specific Antigen and Prostate Volume------Two significant predictors of Seminal Vesicle Invasion in Patients with Prostate Cancer University Hospital of Patras, Patras Greece Prague Medical Report / Vol. 112 (2011) No. 4, p. 263–271 Background the danger of leaving back cancer material if SV left in place during RP is high. Furthermore, SVI is a bad prognostic factor for survival and most of the patients will present early biochemical relapse and will need an adjuvant treatment protocol (radiotherapy, hormone manipulations). 目前认为，前列腺癌手术中保留精囊腺将增加癌组织残留的机会，一般前列腺癌出现精囊转移，往往预示不良的预后，患者术后早期就有可能出现前列腺癌生化复发，并不得不接受进一步的治疗，如放射治疗，内分泌治疗等。 Background 前列腺癌并发精囊腺转移(SVI) 往往提示不良的预后并降低生存率。因此，目前标准的前列腺癌根治术都应该包括完整的切除精囊。 Seminal vesicle invasion (SVI) represents an adverse pathologic and prognostic factor and increases the rates of prostate cancer (PCa) specific mortality. Consequently, the complete removal of seminal vesicles (SV) is included in radical prostatectomy (RP) standard technique Background 但在目前标准的前列腺癌根治术中，膀胱三角区、膀胱颈部和后尿道分布的神经往往会不可避免的被破坏，因为手术的本身操作程序就涉及到前列腺、膀胱后壁和精囊的解剖分离。 During radical prostatectomy, innervation of the trigone, neobladder neck, and posterior urethra may become disrupted, because the surgical procedure involves anatomic dissection around the prostate, posterior aspects of the bladder base, and seminal vesicles. 精囊腺周围紧邻的解剖结构：血管神经束、膀胱三角区的神经……..这些解剖特点，决定了不论在手术当中还是术后组织的纤维化改变，都可能损伤有关控制排尿和性功能的神经和血供，从而影响术后患者的排尿控制和或性功能。 Background SV are in close anatomical relationship with structures like neurovascular bundle and trigonal nerves and this feature has stimulating research in recent years for the potential benefit of SV sparing RP in continence and erectile function outcomes after surgery. Direct lesion during surgery or postoperative fibrotic changes may harm both the nerve and blood supply. Background (A) Standard retropubic radical pros