Yanagizawa R, Hoshino Y
Department of Urology, Tokyo Metropolitan Fuchu Hospital.
Nihon Hinyokika Gakkai Zasshi. 1992 Dec;83(12):2044-9. doi: 10.5980/jpnjurol1989.83.2044.
Between 1970 and 1989, total prostatectomy was performed in 31 patients with prostatic cancer at the Department of Urology, Tokyo Metropolitan Fuchu Hospital. These cases were composed of 4 cases of stage A, 8 cases of stage B and 19 cases of stage C. The surgical procedures were perineal prostatectomy in 25 cases, combined method of perineal and retropubic prostatectomy in 5 cases and transsacral prostatectomy in one case. Blood loss was 762 ml on the average. Blood transfusion was unnecessary in 15 cases all of whom underwent perineal prostatectomy. Endocrine or radiation therapy were administered after total prostatectomy to 23 or 13 cases, respectively. Postoperative complications included early postoperative death due to apoplexy in 1 cases, recto-vesical fistula in 1, bladder neck or urethral stricture in 9 (mild 7, severe 2) and urinary incontinence in 20 (mild 13, moderate 4, severe 3). Frequency and grade of urinary incontinence tended to become higher as the pathological stage progressed. The 5-year survival rates for clinical stage A and B, and C were 83% and 63%, respectively. We conclude that total perineal prostatectomy was less traumatic operation for prostatic cancer, and would be indicated in clinical stage A and B for radical operation and in stage C for one of the combination therapy.
1970年至1989年间，东京都府中病院泌尿外科对31例前列腺癌患者实施了全前列腺切除术。这些病例包括4例A期、8例B期和19例C期。手术方式为经会阴前列腺切除术25例、经会阴与耻骨后联合前列腺切除术5例、经骶骨前列腺切除术1例。平均失血量为762毫升。15例均行经会阴前列腺切除术的患者无需输血。全前列腺切除术后分别有23例和13例接受了内分泌治疗或放射治疗。术后并发症包括1例因中风导致的术后早期死亡、1例直肠膀胱瘘、9例膀胱颈或尿道狭窄（轻度7例，重度2例）以及20例尿失禁（轻度13例，中度4例，重度3例）。尿失禁的发生率和严重程度往往随着病理分期的进展而升高。临床A期和B期以及C期的5年生存率分别为83%和63%。我们得出结论，经会阴全前列腺切除术对前列腺癌而言是创伤较小的手术，适用于A期和B期的根治性手术以及C期作为综合治疗方法之一。
