Department of Urology, Central Hospital of Bolzano, Lorenz Böhler Street 5, 39100 Bolzano, Italy.
Int J Surg. 2011;9(5):400-3. doi: 10.1016/j.ijsu.2011.03.027. Epub 2011 Apr 2.
Radical perineal prostatectomy (RPP) is an alternative to the retropubic, laparoscopic or robotic prostatectomy approaches. This study reports the experience with RPP of a single surgeon at a single institution; the technical aspects, oncological outcome, and complications, such as urinary incontinence and erectile dysfunction, were investigated.
A total of 212 consecutive patients with a mean age of 63 (range 45-74) years and clinically localised prostate cancer were monitored. Between January 2001 and December 2010, all patients underwent RPP that was performed by a single experienced surgeon at one institution. All data were introduced into a database focussing on the intra-operative and post-operative complications, continence rate, potency and oncological outcome.
The mean follow-up was 48 (6-117) months. Intra-operative complications, both early and late, occurred in 19% of the patients. The average length of in-hospital stay was 9 (3-45) days, and the mean period of time spent with a urethral catheter in place was 9 (4-45) days. The continence rate was 81%, and the potency rate, without any pharmacological aid, was 27%. The overall PSA-free survival rate was 86%. There was one cancer-specific death.
On the basis of our prospective data, we conclude that RPP provides satisfactory oncological results with an acceptable outcome in terms of quality of life. RPP can be considered to be mini-invasive and achieves results that are equivalent to those of the alternative surgical approaches.
根治性经会阴前列腺切除术（RPP）是耻骨后、腹腔镜或机器人前列腺切除术的替代方法。本研究报告了一位外科医生在一家机构的 RPP 经验；研究了技术方面、肿瘤学结果以及尿失禁和勃起功能障碍等并发症。
共监测了 212 例平均年龄为 63 岁（范围 45-74 岁）的临床局限性前列腺癌患者。2001 年 1 月至 2010 年 12 月期间，所有患者均在一家机构接受了由一位经验丰富的外科医生进行的 RPP。所有数据均录入了一个数据库，重点关注术中及术后并发症、尿控率、勃起功能和肿瘤学结果。
平均随访时间为 48 个月（6-117 个月）。术中并发症，无论是早期还是晚期，发生在 19%的患者中。平均住院时间为 9 天（3-45 天），尿道置管时间平均为 9 天（4-45 天）。尿控率为 81%，无需任何药物辅助的勃起功能率为 27%。总的 PSA 无复发生存率为 86%。有一例与癌症相关的死亡。
基于我们的前瞻性数据，我们得出结论，RPP 提供了令人满意的肿瘤学结果，在生活质量方面具有可接受的结果。RPP 可以被认为是微创的，并且可以达到与替代手术方法相当的结果。
