Hara Isao, Kawabata Gaku
Department of Urology, Kobe University School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Curr Urol Rep. 2002 Apr;3(2):159-63. doi: 10.1007/s11934-002-0029-0.
Laparoscopic prostatectomy has become an established treatment option for localized prostate cancer in France, where open prostatectomy is now the gold standard. The main purposes of treatment for prostate cancer are cancer control and preservation of urinary continence and sexual function. To become a standard treatment option for organ-confined prostate cancer, laparoscopic prostatectomy has to show equal or better clinical outcome in these areas than its open counterpart. Many institutes in other countries are now trying to perform this surgery. There are, however, some negative reports, mainly because of the difficulty of the procedure. In Japan, more than 250 patients have undergone this surgery. It seems that satisfactory results in terms of positive surgical margin rate, bleeding volume, recovery from surgery, and urinary continence have been obtained so far. We need longer follow-up to assess recurrence rate and sexual function. The main obstacles for this surgery are the long operative time and the difficulty of the procedures. Although it will take time until laparoscopic prostatectomy becomes an approved treatment modality, we are gradually conquering these problems. In this paper, we review the current situation facing laparoscopic prostatectomy in Japan.
在法国，腹腔镜前列腺切除术已成为局限性前列腺癌的一种既定治疗选择，而开放性前列腺切除术目前是金标准。前列腺癌治疗的主要目的是控制癌症以及保留尿失禁和性功能。要成为局限性前列腺癌的标准治疗选择，腹腔镜前列腺切除术必须在这些方面展现出与开放性前列腺切除术相当或更好的临床效果。其他国家的许多机构目前都在尝试开展这种手术。然而，也有一些负面报道，主要是因为该手术难度较大。在日本，已有超过250名患者接受了这种手术。到目前为止，在手术切缘阳性率、出血量、术后恢复以及尿失禁方面似乎都取得了令人满意的结果。我们需要更长时间的随访来评估复发率和性功能。该手术的主要障碍是手术时间长和操作难度大。尽管腹腔镜前列腺切除术成为一种被认可的治疗方式还需要时间，但我们正在逐步克服这些问题。在本文中，我们回顾了日本腹腔镜前列腺切除术面临的现状。
