[腹腔镜淋巴结清扫术。当前适应证]
[Laparoscopic lymphadenectomy. Current indications].
作者信息
Rioja Sanz Carlos, Blas Marín Miguel, Rioja Sanz Luis
机构信息
Servicio de Urología, Hospital Universitario Miguel Servet, Po/Isabel La Católica 1-3 50009 Zaragoza, España.
出版信息
Arch Esp Urol. 2002 Jul-Aug;55(6):667-78.
OBJECTIVES
To analyse the experience of our own group and other reference groups with laparoscopic pelvic lymphadenectomy since 1990 regarding different aspects: Technical details, results, complications, and establishment of its current indications for prostate cancer treatment.
METHODS
We report a retrospective statistical analysis of a series of lymphadenectomies over a 10 year period with a total of 202 cases (69 laparoscopic and 133 open surgical) analysing different lymph node invasion risk factors.
RESULTS
Elevated PSA and Gleason resulted in more lymph node infiltration being the cutting point in 40 and 7 respectively.
CONCLUSIONS
Laparoscopic lymphadenectomy provides equal diagnostic reliability than the traditional technique. Currently we perform laparoscopic lymphadenectomy in prostate cancer for T3 tumours (independently of PSA or Gleason score) and in < T3 with PSA > or = 40, Gleason > or = 8, and in cases with Gleason 7 and PSA > 20.
目的
分析自1990年以来我们自己团队以及其他参考团队在腹腔镜盆腔淋巴结清扫术方面的经验，涉及不同方面：技术细节、结果、并发症以及确定其目前在前列腺癌治疗中的适应证。
方法
我们报告了对一系列为期10年的淋巴结清扫术进行的回顾性统计分析，共202例（69例腹腔镜手术和133例开放手术），分析了不同的淋巴结侵犯风险因素。
结果
PSA升高和Gleason评分分别以40和7为切点导致更多的淋巴结浸润。
结论
腹腔镜淋巴结清扫术与传统技术具有同等的诊断可靠性。目前，对于T3期肿瘤（无论PSA或Gleason评分如何）以及PSA≥40、Gleason≥8的＜T3期肿瘤，以及Gleason评分为7且PSA＞20的病例，我们采用腹腔镜淋巴结清扫术治疗前列腺癌。
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