经尿道前列腺电切术后的腹腔镜下前列腺癌根治术

Laparoscopic radical prostatectomy for incidental prostate cancer after TURP

目的探讨TURP术后发现前列腺癌行腹腔镜下前列腺癌根治术的手术技巧及经验。方法2007年4月至2010年7月收治既往行TURP术后发现前列腺癌的患者5例，平均年龄73岁，TURP术后平均（2．8±1．1）个月行腹腔镜下前列腺癌根治术。结果5例手术顺利完成，其中经腹腔途径1例，经腹膜外途径4例。平均手术时间（227．6±38．4）min，术中平均出血（130．0±152．5）ml，术后平均随访（16．1±15．9）个月，最长40个月，5例均存活，控尿功能好，无明显尿失禁。结论TURP术后行腹腔镜下前列腺癌根治术疗效满意，先前的TURP术增加了腹腔镜操作难度，但在腹腔镜技术熟练的条件下是可行的。

Objective To describe our experience in laparoscopic radical prostatectomy （LRP） for incidental prostate cancer after TURP. Methods From April 2007 to July 2010, 5 patients with incidental prostate cancer after TURP were treated with a mean age of 73 years. The patients underwent LRP （2.8± 1. 1） months after TURP. Results The five cases of LRP were performed suc cessful[y, with 1 case of transperitoneal approach and 4 cases of extraperitoneal approach. Mean operation time was （227.6±38.4） min, mean blood loss was （130±152.5） ml, and the mean follow-up was （16. 1± 15.9） months. All five patients survived, and their urinary function was good without any incontinence. Conclusions Previous TURP represents a technical challenge when performing LRP, but highly skilled surgeons trained to perform LRPs can handle it.