Center for Gastrointestinal Malignancies, MedStar Washington Hospital Center, Washington, DC, USA.
Eur J Surg Oncol. 2018 Jun;44(6):805-809. doi: 10.1016/j.ejso.2018.01.009. Epub 2018 Jan 12.
Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) may be of greatest benefit if all visible evidence of disease is resected. In some male patients the peritoneal metastases within the pelvis are invasive into the seminal vesicles and complete cytoreduction requires resection of these structures.
From a prospective database of colorectal and appendiceal cancer patients who had CT evidence of seminal vesicle involvement and then had cytoreduction including resection of the seminal vesicles were reviewed. Their clinical features were tabulated.
Five patients were identified between ages 52 and 60. Three of 5 were appendiceal mucinous neoplasms and 4 of 5 had complete cytoreduction. Two of the patients are long-term survivors of 120 and 28 months. All patients are impotent and reported no return of sexual function over time. All five patients report normal micturition.
Resection of the seminal vesicles in a patient with invasion of these structures by peritoneal metastases is possible and should be considered in selected patients. This resection causes impotence but normal urination is to be expected.
如果切除所有可见的疾病证据，细胞减灭术 (CRS) 联合腹腔内热化疗 (HIPEC) 可能最有益。在一些男性患者中，盆腔内的腹膜转移灶侵犯精囊，要实现完全减瘤则需要切除这些结构。
从接受 CT 检查证实有精囊受累且随后接受包括切除精囊的细胞减灭术的结直肠和阑尾癌患者的前瞻性数据库中对这些患者进行了回顾性分析。他们的临床特征被列表记录。
5 名患者的年龄在 52 岁至 60 岁之间。5 名患者中有 3 名患有阑尾黏液性肿瘤，5 名患者中有 4 名实现了完全减瘤。2 名患者为长期幸存者，生存时间分别为 120 个月和 28 个月。所有患者均丧失性功能且无性功能随时间恢复的报告。所有 5 名患者均报告正常排尿。
对腹膜转移灶侵犯这些结构的患者进行精囊切除术是可行的，应在选择的患者中考虑这一手术。这种切除会导致阳痿，但预计排尿正常。
