Fragkoulis Charalampos, Pappas Athanasios, Theocharis Georgios, Papadopoulos Georgios, Stathouros Georgios, Ntoumas Konstantinos
Department of Urology, Athens General Hospital 'G. Gennimatas', Athens, Greece.
Can J Urol. 2018 Apr;25(2):9262-9267.
To demonstrate any differences in the perioperative, functional and oncologic outcomes after radical retropubic prostatectomy (RRP) among those patients having previously performed transurethral resection of prostate (TURP) and those not.
A total of 35 patients were diagnosed with prostate cancer (T1a and T1b) after TURP, underwent RRP and completed a 1 year follow up (group A). They were matched with a cohort of another 35 men (group B) in terms of age, body mass index (BMI), prostatic specific antigen (PSA), Gleason score, prostate volume (before surgery), pathological stage and neurovascular bundle-sparing technique. That was a retrospective study completed between September 2011 and March 2014.
Not a significant difference was demonstrated among the two groups of patients concerning the functional and oncologic results. On the other hand, previous prostate surgery made the operation procedure more demanding. Besides, operative time and blood loss (though not translated in transfusion rates) were higher among patients in group A. Besides, catheter removal in group A patients was performed later than their counterparts of group B.
RRP after TURP is a relatively safe procedure and in the hands of experienced surgeons, a previously performed TURP, does not seem to compromise oncologic outcomes of the operation. Continence is preserved, though erectile function seems to be compromised compared with patients undergoing RRP without prior TURP. Moreover, defining the prostate and bladder neck margins can be challenging and the surgeon has to be aware of the difficulties that might confront.
为了证明既往接受经尿道前列腺切除术（TURP）的患者与未接受该手术的患者在耻骨后根治性前列腺切除术（RRP）后的围手术期、功能和肿瘤学结局方面是否存在差异。
共有35例患者在TURP后被诊断为前列腺癌（T1a和T1b），接受了RRP并完成了1年的随访（A组）。根据年龄、体重指数（BMI）、前列腺特异性抗原（PSA）、Gleason评分、前列腺体积（术前）、病理分期和保留神经血管束技术，将他们与另外35名男性组成的队列（B组）进行匹配。这是一项在2011年9月至2014年3月期间完成的回顾性研究。
两组患者在功能和肿瘤学结果方面未显示出显著差异。另一方面，既往的前列腺手术使手术操作要求更高。此外，A组患者的手术时间和失血量（尽管未转化为输血率）更高。此外，A组患者拔除导尿管的时间比B组患者晚。
TURP后行RRP是一种相对安全的手术，在经验丰富的外科医生手中，既往进行的TURP似乎不会影响手术的肿瘤学结局。控尿功能得以保留，尽管与未行TURP的RRP患者相比，勃起功能似乎受到了影响。此外，确定前列腺和膀胱颈切缘可能具有挑战性，外科医生必须意识到可能面临的困难。
