Nakamura Kogenta, Kasraeian Ali, Anai Satoshi, Pendleton John, Rosser Charles J
Department of Urology, University of Florida, Gainesville, FL 32610, USA.
Int Braz J Urol. 2007 Nov-Dec;33(6):746-51. doi: 10.1590/s1677-55382007000600002.
To determine if intraoperative frozen sections of the bladder neck during radical prostatectomy (RP) could decrease the incidence of final positive surgical margins at the bladder neck.
This prospective cohort study included 51 consecutive men who underwent anatomic RP at University of Florida & Shands Jacksonville. All patients had intraoperative frozen section of bladder neck sent for analysis. Preoperative, operative, and postoperative data were collected and analyzed.
Outcome measures were intraoperative bladder neck margin status, final pathologic bladder neck margin status, and postoperative urinary complications. Median follow-up for the 51 patients was 22 months.
The final positive surgical margin rate was 20% (10 patients). An additional three patients had positive surgical margins at the bladder neck intraoperatively. These patients then had a wider resection of the affected bladder neck until the frozen sections were negative for cancer or prostatic tissue. Final pathologic evaluation of bladder neck margin was negative for tumor or persistent prostatic tissue in all 51 men.
With intra-operative frozen sections, we were able to obtain a negligible positive bladder neck margin rate. Surgeons who are still on the learning curve for RP should consider intra-operative frozen section of the bladder neck.
确定根治性前列腺切除术（RP）期间膀胱颈部的术中冰冻切片是否能降低膀胱颈部最终手术切缘阳性的发生率。
这项前瞻性队列研究纳入了51例在佛罗里达大学和杰克逊维尔尚德医院接受解剖性RP的男性患者。所有患者均送检膀胱颈部术中冰冻切片进行分析。收集并分析术前、术中及术后数据。
观察指标为术中膀胱颈部切缘状态、最终病理膀胱颈部切缘状态及术后泌尿系统并发症。51例患者的中位随访时间为22个月。
最终手术切缘阳性率为20%（10例患者）。另外3例患者术中膀胱颈部手术切缘阳性。这些患者随后对受影响的膀胱颈部进行了更广泛的切除，直到冰冻切片癌症或前列腺组织呈阴性。所有51例男性患者膀胱颈部切缘的最终病理评估肿瘤或残留前列腺组织均为阴性。
通过术中冰冻切片，我们能够获得可忽略不计的膀胱颈部切缘阳性率。仍处于RP学习曲线阶段的外科医生应考虑膀胱颈部术中冰冻切片。
