经尿道前列腺电切术在前列腺癌早期诊治中的意义

Transurethral Prostate Electrocision in the Early Diagnosis of Prostate Cancer

目的探讨经尿道前列腺电切术在前列腺癌早期诊治中的意义。方法选取我院2002年5月—2010年3月膀胱出口梗阻患者18例,采用经尿道前列腺电切术治疗,术后病理明确为前列腺癌,TNM分期为T1a^b。其中10例行前列腺癌根治术,5例行内分泌治疗,3例行保守观察。结果 10例前列腺癌根治术患者围术期无死亡及严重并发症,3例发生尿道狭窄,1例真性尿失禁。5例内分泌治疗患者3个月血清前列腺特异性抗原(PSA)均降至参考范围内。2例于术后1年失访(PSA在参考范围),其余随访2.5~7.0年,平均4.2年,均无瘤存活。3例发生尿道狭窄患者定期尿道扩张后好转。结论经尿道前列腺电切术能够提高早期前列腺癌的检出,前期电切术不妨碍后期的前列腺癌根治术及其他治疗。

Objective To explore the significance of transurethral prostate electrocision in the early diagnosis and treatment of prostate cancer.Methods A total of 18 patients with bladder outlet obstruction who had received transurethral prostate electrocision treatment in our hospital from May 2002 to March 2010 were enrolled,all diagnosed as prostate cancer by postoperative pathology examination（TNM stages：T1a^b）.Of these cases,10 received radical prostatectomy,5 received endocrine therapy,with another 3 underwent conservative observation.Results Aside from 3 cases of urethral stricture and 1 case of genuine urinary incontinence,no perioperative death or serious complications were noted among the 10 cases of radical prostatectomy,The serum PSA levels fell back to reference range in the 5 cases of endocrine therapy 3 months after the operation.All patients survived the subsequent follow-up duration ranging from 2.5 to 7.0 years（with an average of 4.2years） with no tumors,except for the 2 cases（with normalized PSA levels） who losted follow-up 1 year later.The 3 cases of urethral stricture showed improved condition after urethral dilatation on a regular basis.Conclusion Detection rates of early prostate cancer can be enhanced by transurethral prostate electrocision,which did not interfere with the subsequent radical prostatectomy or other treating procedures.