腹腔镜下同期前列腺癌和直肠癌根治术初步体会并文献复习

Combined laparoscopic radical resection of synchronous prostate and rectal cancer:Preliminary experience of 2 cases

目的:回顾临床治疗的前列腺癌合并直肠癌病例,总结同期联合腹腔镜前列腺癌根治术和直肠癌根治术的初步经验并进行文献复习。方法:2例直肠癌并发前列腺癌患者在2014—2015年,同期接受联合腹腔镜前列腺癌根治术和直肠癌根治术,并进行术后病理确认。结果:均顺利完成手术,均未出现严重并发症。术后病理:病例1为pT2cN0M0前列腺癌,pT3N0M0直肠癌;病例2为pT2aN0M0前列腺癌和pT2N0M0直肠癌。术后6个月CT扫描未发现局部复发。分别随访7年和6年后,2例患者的PSA均<0.008ng/ml,直肠癌完全缓解。结论:结合我们的初步经验和文献复习,腹腔镜前列腺癌根治术和直肠癌根治术同期进行是可行的,联合2个微创手术可以使患者获益。

Objective:Synchronous prostate and rectal cancer is rare.The purpose of this article is to present our preliminary experience of combined laparoscopic radical prostatectomy and rectal resection.Methods:From 2014 to 2015,two men with newly diagnosed rectal cancer were revealed to have concurrent prostate cancer.Both of them received laparoscopic radical prostatectomy and low anterior resection(LAR)of the rectum simultaneously.Results:The stages of their cancers for the first patient were pT2cN0M0 with prostate cancer and pT3N0M0 with rectal cancer;for the second patient were T2aN0M0 with prostate cancer and T2N0M0 with rectal cancer.Both of the patients had excellent functional and oncologic outcomes.No major complication occurred.Both patients had a PSA level under 0.008ng/ml and remission of rectal cancer after 7 years and 6 years follow-up,seperately.Conclusion:Laparoscopic radical prostatectomy and rectal resection can be performed simultaneously according to our preliminary experience and literature review.Minimal invasive technique could be efficient and cost-effective.