Eden Christopher G, Moon Daniel A
Department of Urology, The North Hampshire Hospital, Basingstoke and The Royal Surrey County Hospital, Guildford, UK.
BJU Int. 2006 May;97(5):981-4. doi: 10.1111/j.1464-410X.2006.06090.x.
To present the results of the first 100 patients in the UK treated by laparoscopic radical prostatectomy (LRP) and with at least 3 years of follow-up, as LRP continues to develop as a minimally invasive alternative to open radical prostatectomy.
In all, 100 patients (mean age 62 years, range 52-72) had a transperitoneal LRP by one surgeon during a 25-month period from 2000 to 2002. Most (78%) patients had a prostate-specific antigen level of 4-10 ng/mL, clinical stage T1 disease (62%), and Gleason 6 on biopsy (50%). Sixty-four patients had unilateral or bilateral nerve preservation and 14 had pelvic lymphadenectomy.
The mean operative duration was 245 min, with a 1% conversion rate. Three patients received a blood transfusion and three had major complications, including a rectal injury. The positive margin rate was 16% and correlated with pathological variables. At > or = 3 years of follow-up (mean 3.7) the overall survival rate was 99% and the biochemical progression-free survival was 88% in all patients, at 90% for pT2 and 75% for pT3. Ninety patients used 0-1 pads/day (84% pad-free) and 60 undergoing nerve preservation retained erectile function.
This series includes the first results for LRP with a > or = 3-year follow-up reported from the UK, with oncological control and morbidity comparable to those in previously published open and laparoscopic series. The history of open radical prostatectomy suggests that as the technique of LRP develops and experience with it increases, these results are likely to improve.
随着腹腔镜根治性前列腺切除术（LRP）作为开放性根治性前列腺切除术的一种微创替代方法不断发展，本文呈现英国首批100例接受LRP治疗且至少随访3年患者的结果。
2000年至2002年的25个月期间，共有100例患者（平均年龄62岁，范围52 - 72岁）由一名外科医生实施经腹LRP。大多数（78%）患者前列腺特异性抗原水平为4 - 10 ng/mL，临床分期为T1期疾病（62%），活检 Gleason评分为6分（50%）。64例患者进行了单侧或双侧神经保留，14例进行了盆腔淋巴结清扫。
平均手术时长为245分钟，中转率为1%。3例患者接受了输血，3例发生了严重并发症，包括直肠损伤。切缘阳性率为16%，与病理变量相关。在随访≥3年（平均3.7年）时，所有患者的总生存率为99%，生化无进展生存率为88%，pT2期患者为90%，pT3期患者为75%。90例患者每天使用0 - 1片尿垫（84%无需使用尿垫），60例接受神经保留的患者保留了勃起功能。
本系列包含英国报道的LRP随访≥3年的首批结果，肿瘤学控制和发病率与先前发表的开放性和腹腔镜系列相当。开放性根治性前列腺切除术的发展历程表明，随着LRP技术的发展和经验的增加，这些结果可能会得到改善。
