耻骨后前列腺癌根治术32例临床剖析.docVIP

耻骨后前列腺癌根治术32例临床剖析 　　【摘要】 目的 探讨耻骨后前列腺癌根治术的手术效果,并总结其经验。方法 对32例诊断为B1期及B2期的前列腺癌患者行耻骨后前列腺癌根治术。结果 平均手术时间3.4 h,术中平均出血量 560 ml。术后 3 个月PSA、术后 6 个月最大尿流率、平均尿流率、剩余尿及前列腺症状评分与术前比较差异有统计学意义(P0.05)。术后病理报告:肿瘤均局限于包膜内。随访6～24个月,平均14个月,均存活。无直肠、输尿管损伤,无完全性尿失禁及手术死亡发生。术后1～2个月患者均恢复完全控尿。术后51.9%恢复勃起功能。结论 耻骨后前列腺癌根治术是局限性前列腺癌的首选治疗方法,充分的术前准备和术后严密随访有利于提高生存率。 　　【关键词】 前列腺癌;前列腺切除术;耻骨后 　　 　　Clinical analysis of 32 cases of prostatic cancer in the treatment of retropubic radical prostatectomy 　　 　　CHEN Qiang-hua.Department of Urology, Dong-an People’s Hospital,Dong-an, Hunan, 425900,China 　　 　　【Abstract】 Objective To probe into the surgic results of the retropubic radical prostatectomy and sum up experience.Methods 32 patients diagnosed as B1 or B2 phase period of prostate cancer were performed on retropubic radical prostatectomy. Results The average operative time was 3.4 h;the average intraoperative 　　 　　作者单位:425900湖南省东安县人民医院泌尿外科 　　 　　 blood loss was 560 ml.3 months after operation of PSA, after 6 months, maximum urinary flow rate, average urinary flow rate, residual urine, prostate symptom score, compared with preoperative period, difference was significant (P0.05).Pathological Report showed tumors were confined within the envelope. Follow-up6~24 months, an average of 14 months, patients all survived and had no rectum, ureter injury, urinary incontinence.1~2 months later, patients had resumed full control of urine. 51.9% of patients recoverd erectile function.Conclusion Retropubic radical prostatectomy is the first choice for localized prostate cancer treatment. Adequate preoperative preparation and postoperative follow-up help improve the survival rate. 　　【Key words】 Prostatic cancer;Radical retropubic prostatectomy;Retropubic 　　 　　前列腺癌根治术是目前治疗早期前列腺癌的标准治疗方法[1]。2004年3月至2008年12月,作者对32例临床早期前列腺癌患者行耻骨后前列腺癌根治术(RRP),效果满意,现报告如下。 　　1 资料与方法 　　1.1 一般资料 本组32例患者,年龄58～73岁,平均65.5岁,前列腺癌临床分期B?1期19例,B2期13例。所有病例均以排尿困难就诊,无尿潴留史,有22例门诊定期复查前列腺特异抗原(PSA)发现升高,术前PSA 7.8～37.6 ng/ml,平均18.2 ng/ml。最大尿流率为(5.4±1.4)