经尿道前列腺电切术后的耻骨后前列腺癌根治术（附20例报告）

Radical retropubic prostatectomy for incidental prostate cancer after TURP（report of 20 cases）

目的探讨TURP术后发现的前列腺偶发癌行耻骨后前列腺癌根治术的心得体会.方法回顾性分析2003年7月至2012年7月宁波市第二医院收治的20例前列腺偶发癌患者资料,平均年龄（65±10）岁, TURP 术后（2.9±1.5）个月行耻骨后前列腺癌根治术.结果20例手术均成功完成.平均手术时间（190.6±38.5）min,术中平均出血（450.0±152.5）ml.无死亡,无直肠损伤.1例切缘阳性.2例报告为BPH.平均随访（60.2±33.9）月,最长108个月,1例出现顽固性尿失禁,其余控尿功能好.无远处淋巴结、骨及其他器官转移.随访PSA未见生化复发.结论 TURP手术史增加了前列腺癌根治手术难度,但耻骨后前列腺癌根治术仍可作为前列腺偶发癌的标准而有效的外科治疗方法.

Objective To summarize clinical experience of retropubic prostatectomy （RRP） for incidental prostate cancer（IDPC） after TURP. Methods From July 2003 to July 2012 ,20 patients, whose mean age was 65 years old, with IDPC after TURP were treated by PPR. RRP was done at （2.9±1.5） months after TURP. Results The 20 cases of RRP were performed successfuny, Mean operation time was（190.6±38.5）min, mean blood loss was （450.0±152.5）ml, and the mean follow-up was （60.2±33.9）months, All twenty patients survived, with only 1 case of urinary incontinence and 1 case of positive surgical margin. Conclusions Previous TURP showed a technical challenge for further RRP perforrmance, but RRPs was still a good method for incidental prostate cancer after TURP under work of highly skilled surgeons.