解剖性耻骨后根治性切除前列腺26例

Anatomical radical retropubic prostatectomy in 26 patients

目的:总结解剖性耻骨后根治性切除前列腺手术的疗效及手术经验。方法:对2005年6月至2010年10月广州医学院附属市一人民医院泌尿外科采用解剖性耻骨后根治性切除前列腺手术26例,局限性前列腺癌患者的临床资料进行回顾性分析。结果:26例手术顺利,平均手术时间(158±95)min,术中平均出血量(650±368)mL。术后病理报告均为前列腺腺癌,临床病理分期T_1 5例,T_2 21例。术后随访3～40个月,平均(20.3±9.6)个月。随访期间无患者死亡。尿失禁7例,3例在术后3个月恢复控尿,2例在术后6个月恢复控尿,1例在术后12个月恢复控尿,1例需使用阴茎头集尿器。术前有勃起功能的12例患者中,9例恢复勃起功能。无直肠、输尿管等周围脏器损伤。结论:解剖性耻骨后根治性切除前列腺手术并发症发生率低,手术效果良好,是局限性前列腺癌的标准治疗方法。

Objective： To analyze the efficacy and surgical experience with anatomical radical retropubic prostatectomy. Methods： Clinical data of 26 patients who underwent anatomical radical retropubic prostatectomy in Department of Urology, First Municipal People＇s Hospital of Guangzhou Medical College between June 2006 and October 2010 were retrospectively analyzed. Results： Surgery was uneventful in all of the 26 patients. The mean operative time was （ 158 ± 95 ） minutes, and the mean intraoperative blood loss was （ 650 ± 368 ） ml. Postoperative pathology revealed prostate cancer in all of the cases, including 5 cases of T1 and 21 of T2 stages. No death was noted during the follow up for a mean of 20.3 ~ 9.6 months （ range ： 3 to 40 months）. Of 7 patients who developed urinary incontinence after the operation, three regained full control of their urine flow at 3 months, two at 6 months, one at 12 months later, while one necessitated persistent use of a urine collector. Sexual function recovered in 9 out of the 12 cases who had erectile function before operation. No injuries to rectum, ureters or other organs were reported. Conclusion： Anatomical radical retropubic prostatectomy is associated with few complications and good surgical outcomes, and therefore may be a standard treatment for localized prostate cancer.