原发性精囊腺癌的腹腔镜治疗

Laparoscopic surgery for primary adenocarcinoma of seminal vesicle

目的探讨经腹入路腹腔镜治疗原发性精囊腺癌的方法和疗效。方法本组3例,术前判断早期未侵犯前列腺2例,肿瘤侵犯前列腺1例,手术采用经腹入路腹腔镜单纯精囊腺切除术或精囊腺加前列腺切除术并行膀胱尿道吻合术。结果3例手术均在腹腔镜下顺利完成,无中转开放,手术时间120～200min,出血量50～300ml,术中无直肠损伤等并发症,术后恢复良好,术后病理为精囊腺癌,2例侵犯前列腺,切缘无阳性。随访8～25月无肿瘤复发。结论腹腔镜经腹入路行精囊腺恶性肿瘤手术切除创伤小,可根据肿瘤的范围、周围器官受累情况,选择单纯精囊及肿瘤切除、前列腺精囊及肿瘤切除或盆腔其他受侵犯脏器切除,术中应注意直肠损伤等并发症。

Objective To evaluate the laparoscopic surgery for primary adenocarcinoma of seminal vesicle by transperitoneal approach.Methods Laparoscopic surgery was carried out in 3 cases of primary adenocarcinoma of seminal vesicle,of which 1 case of prostate invasion was verified.The transperitoneal laparoscopic resection or resection of the prostate with seminal vesicles plus vesicourethral anastomosis were performed for seminal vesicles resection.Results Laparoscopic procedures were completed in all cases.No patients were transferred to open surgery.The operating time ranged from 120 to 200 minutes.And the blood loss ranged from 50 to 300 ml.No complications,such as rectum injury,were observed.All the patients recovered well.There was no evidence of recurrence after follow-up of 8 25 months.Conclusions Transperitoneal laparoscopic surgery is a minimal invasive method for treating adenocarcinoma of seminal vesicle.Different approaches are suggested according to extent of the tumor and involvement of surrounding organs.