Saema Armean, Patcharatrakul Suthep, Kongchareonsombat Wisoot
Division of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2013 May;96(5):633-6.
To report the authors' experience in laparoscopic radical prostatectomy for the treatment of localized prostate carcinoma in a cadaveric renal transplant recipient.
A 64-year-old man with chronic renal failure unknown cause had a transplant cadaveric donor kidney about nine years ago. Creatinine clearance was estimated about 68.61 ml/min. He was presented with lower urinary tract symptoms in 2008. He was diagnosed and was treated as benign prostatic hyperplasia. Digital rectal examination was normal and prostate specific antigen (PSA) was 10.84 ng/ml when he was followed-up in 2010. The authors did a prostate gland biopsy, one of four cores from right lobe of prostate gland revealed prostatic adenoma with Gleason score of 6 (3 + 3). Bone scan did not show any sign of metastases. The authors performed a Laparoscopic radical prostatectomy, extraperitoneal technique.
The patient underwent successful laparoscopic radical prostatectomy without any complications. The operative time was 210 minutes, the estimated blood loss of 300 ml. Pathological analyses revealed negative surgical margins with focal extraprostatic extension, and no seminal vesical, lymphatic, and perineural invasion. The patient tolerated the procedure well and was discharged on day 4. At fourth months, the patient was continent, PSA was 0.003, and renal function stable. At one year, PSA was 0.011 ng/ml and the creatinine was 1.15 mg/dl.
The authors experience suggests that extraperitoneal laparoscopic radical prostatectomy is a technically feasible and safe treatment of localized prostate cancer in renal transplant recipients.
报告作者对一名尸体肾移植受者进行腹腔镜前列腺癌根治术治疗局限性前列腺癌的经验。
一名64岁病因不明的慢性肾衰竭男性，约9年前接受了尸体供肾移植。估计肌酐清除率约为68.61 ml/min。他在2008年出现下尿路症状，被诊断为良性前列腺增生并接受治疗。2010年随访时，直肠指检正常，前列腺特异性抗原（PSA）为10.84 ng/ml。作者进行了前列腺活检，前列腺右叶四个活检组织芯中的一个显示为Gleason评分为6（3+3）的前列腺腺瘤。骨扫描未显示任何转移迹象。作者采用腹膜外技术进行了腹腔镜前列腺癌根治术。
患者成功接受腹腔镜前列腺癌根治术，无任何并发症。手术时间为210分钟，估计失血量为300 ml。病理分析显示手术切缘阴性，有局灶性前列腺外侵犯，无精囊、淋巴管及神经周围侵犯。患者对手术耐受良好，术后第4天出院。术后4个月，患者控尿良好，PSA为0.003，肾功能稳定。术后1年，PSA为0.011 ng/ml，肌酐为1.15 mg/dl。
作者的经验表明，腹膜外腹腔镜前列腺癌根治术是治疗肾移植受者局限性前列腺癌的一种技术上可行且安全的方法。
