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盆腔手术后的腹膜外腹腔镜前列腺根治术

extraperitoneoscopic radical prostatectomy after pelvic sugery procedures.

作者信息

Serniak Yuriy P, Sagalevych Andriy I, Frolov Oleksandr S, Serniak Petr Y, Kryvopustov Mykola S

机构信息

Urological Clinic of Professor Serniak, Kyiv, Ukraine.

Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine.

出版信息

Wiad Lek. 2020;73(6):1093-1096.

Abstract

OBJECTIVE

The aim of study is to evaluate the results of extraperitoneoscopic radical prostatectomy performed in the presence of various complicating factors.

PATIENTS AND METHODS

Materials and methods: This prospective study included 7 patients with a diagnosis of prostate cancer (T1-T2b, No, Mo) who underwent extraperitoneoscopic radical prostatectomy (ERPE).

RESULTS

Results: Among all ERPEs performed on seven patients, the maximum duration of the surgery was 6 hours 30 minutes, and the minimum one was 3 hours 40 minutes. The average volume of blood loss did not exceed 350±20 ml; decline in hemoglobin level was in the range of 10-12 g/l. The urethral catheter was removed no earlier than 7 days after the surgery. Drainage from the space of Retzius was removed on the 3rd day. Postoperative complications occurred in 2 patients (28.57%). The maximum period of postoperative outpatient follow-up was 22 months. In 6 patients (85.71%), complete urinary retention up to 3 months was noted. One patient (14.29%) had mild urinary incontinence (PADtest - no more than one pad per day). In these cases, sexual potency was absent in 100% of patients. The maximum postoperative PSA level in the group reached 0.13 ng/ ml.

CONCLUSION

Conclusions: Own experience of ERPE in patients on the background of previous transurethral resections and vaporization of the prostate demonstrated the effectiveness and safety of the method. More extensive studies with a larger number of cases are needed.

摘要

目的

本研究旨在评估在存在各种复杂因素的情况下进行腹膜外腹腔镜根治性前列腺切除术的结果。

患者与方法

材料和方法:这项前瞻性研究纳入了7例诊断为前列腺癌(T1-T2b,No,Mo)并接受腹膜外腹腔镜根治性前列腺切除术(ERPE)的患者。

结果

结果:在对7例患者进行的所有ERPE手术中,手术最长持续时间为6小时30分钟,最短为3小时40分钟。平均失血量不超过350±20毫升;血红蛋白水平下降范围为10-12克/升。术后至少7天拔除尿道导管。耻骨后间隙引流在术后第3天拔除。2例患者(28.57%)发生术后并发症。术后门诊随访最长时间为22个月。6例患者(85.71%)出现长达3个月的完全尿潴留。1例患者(14.29%)有轻度尿失禁(护垫试验——每天不超过1片护垫)。在这些病例中,100%的患者性功能丧失。该组术后最高PSA水平达到0.13纳克/毫升。

结论

结论:在既往经尿道前列腺切除术和前列腺汽化术背景下对患者进行ERPE的自身经验证明了该方法的有效性和安全性。需要进行更多病例的广泛研究。

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