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经尿道前列腺全切除术后作为前列腺癌治疗的替代疗法的控尿率和肿瘤学可行性:一项初步研究。

Continence rate and oncological feasibility after total transurethral resection of the prostate as an alternative therapy for the treatment of prostate cancer: a pilot study.

机构信息

Department of Urology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.

出版信息

Int Neurourol J. 2011 Dec;15(4):222-7. doi: 10.5213/inj.2011.15.4.222. Epub 2011 Dec 31.

Abstract

PURPOSE

The value of total transurethral resection of prostate cancer (TURPC) as an alternative therapy was first recognized by Hans J. Reuter. Thus, we conducted the study of prospectively collected data to verify total TURPC as an alternative therapy forlocalized prostate cancer.

METHODS

From January 2008 to July 2011, 14 patients with a mean age of 76.1 years (range, 66 to 89 years) with clinically localized prostate cancer were treated by prostatic resection by the corresponding author with curative intention.

RESULTS

The mean duration of TURPC was 51.7 minutes (range, 30 to 120 minutes) and the mean amount of prostatic tissue resected was 21.2 g (range, 5 to 66 g). An intra- and/or postoperative blood transfusion was necessary in 2 cases. Hyponatremia was found in 7 patients. Six months after TURPC, 3 cases of grade 1 and 1 case of grade 2 incontinence were observed. Three patients in the high-risk group did not achieve a prostate specific antigen (PSA) nadir of ≤0.2 ng/mL. PSA recurrence occurred in one case in our series. Newly developed lymph node or distant metastases were not observed during the follow-up period.

CONCLUSIONS

According to our results, transurethral resection for prostate cancer can be performed with reasonable oncological results. The PSA nadir levels, and rates of biochemical failure and postoperative complications, including incontinence, were comparable with the published results for other procedures. TURPC is also inexpensive and non-invasive, and requires short hospitalization and a short surgical time without vesicourethral anastomosis.

摘要

目的

经尿道前列腺全切除术(TURPC)作为一种替代疗法的价值最初是由 Hans J. Reuter 认识到的。因此,我们进行了这项前瞻性收集数据的研究,以验证 TURPC 作为局限性前列腺癌的一种替代治疗方法。

方法

自 2008 年 1 月至 2011 年 7 月,作者对 14 例年龄均为 76.1 岁(范围 66 至 89 岁)的局限性前列腺癌患者进行了前列腺切除术,具有治愈性意图。

结果

TURPC 的平均时间为 51.7 分钟(范围 30 至 120 分钟),切除的前列腺组织平均为 21.2 克(范围 5 至 66 克)。2 例需要术中及/或术后输血。7 例出现低钠血症。TURPC 后 6 个月,观察到 3 例 1 级和 1 例 2 级尿失禁。高风险组的 3 例患者未达到 PSA 最低值≤0.2ng/mL。在我们的研究中,有 1 例患者 PSA 复发。在随访期间,未发现新的淋巴结或远处转移。

结论

根据我们的结果,经尿道前列腺切除术可获得合理的肿瘤学结果。PSA 最低值、生化失败率以及包括尿失禁在内的术后并发症发生率与其他手术程序的发表结果相当。TURPC 也具有成本效益,非侵入性,需要短时间住院和手术时间,无需进行膀胱尿道吻合术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3cc2/3256308/c5f7e6f156ea/inj-15-222-g001.jpg

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