Hayashi Mutsuo, Shinmei Shunsuke, Asano Kosuke
Takanobashi Central Hospital, 2-4-16 Kokutaiji-cho Naka-ku, Hiroshima, Japan.
Int J Urol. 2007 Nov;14(11):1048-50. doi: 10.1111/j.1442-2042.2007.01880.x.
Four patients with biochemical prostate-specific antigen (PSA) failure with suspected local recurrence at the vesico-urethral anastomotic site after radical prostatectomy were treated using a high-intensity focused ultrasound (HIFU) device (Sonablate 500) under caudal or spinal anesthesia. The pretreatment PSA levels ranged from 0.318 to 0.898 ng/mL and their Gleason scores ranged between 5 and 7. HIFU treatment was carried out six times in four patients. The median time of operation and follow-up period were 30 min (range, 15-37) and 13 months (range, 7-18), respectively. In all patients, the median PSA levels decreased from 0.555 ng/mL (range, 0.318-0.898) to 0.137 ng/mL (range, 0.102-0.290). The median PSA nadir after each HIFU was 0.054 ng/mL (range, 0.008-0.097). No major complications were noted. HIFU may be useful for the therapy of vesicourethral anastomostic lesion in patients with PSA failure after prostatectomy.
对4例根治性前列腺切除术后在膀胱尿道吻合部位疑似局部复发且出现生化前列腺特异性抗原（PSA）失败的患者，在骶管或脊髓麻醉下使用高强度聚焦超声（HIFU）设备（Sonablate 500）进行治疗。治疗前PSA水平为0.318至0.898 ng/mL，Gleason评分在5至7分之间。4例患者均接受了6次HIFU治疗。手术中位时间和随访期分别为30分钟（范围15 - 37分钟）和13个月（范围7 - 18个月）。所有患者中，PSA中位数水平从0.555 ng/mL（范围0.318 - 0.898）降至0.137 ng/mL（范围0.102 - 0.290）。每次HIFU治疗后PSA最低点中位数为0.054 ng/mL（范围0.008 - 0.097）。未观察到重大并发症。HIFU可能对前列腺切除术后PSA失败患者的膀胱尿道吻合口病变治疗有用。
