Liao J, Liu X, DU W, Guo K, Xu Y
Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.
Shayuan Street Community Health Service Center, Guangzhou 510280, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2023 Dec 20;43(12):2158-2162. doi: 10.12122/j.issn.1673-4254.2023.12.23.
A 67-year-old male patient was referred to our hospital by the community health service center for "sudden dysuria for half a day". The diagnosis of solitary fibrous tumor of the prostate was established after transrectal prostate biopsy. After excluding contraindications, laparoscopic radical prostatectomy with bladder neck urethrostomy was performed. The operation was completed in 3 h and 15 min with an intraoperative blood loss of about 100 mL. Postoperative examination of the resected tumor revealed a large spherical tumor mass measuring about 11 cm×7.5 cm×6 cm with a net weight of 223 g. Postoperative pathology suggested solitary fibrous tumor of the prostate (medium-risk type). The abdominal drainage tube was removed 5 days after the operation and the catheter was removed 1 week after operation. The patient had good urine control at night without incontinence but with occasional urine leakage during daytime, and the overall therapeutic effect was satisfactory. Postoperative follow-up found good urine control of the patient without signs of tumor recurrence or metastasis. Laparoscopic radical prostatectomy often is difficult for large prostate tumors with a weight exceeding 200 g, and requires the surgeon to have rich experience in laparoscopic surgery with good understanding of prostate anatomy and close cooperation of the operation team to achieve satisfactory oncology control and functional protection of the urinary system.
一名67岁男性患者因“突发排尿困难半天”被社区卫生服务中心转诊至我院。经直肠前列腺穿刺活检后确诊为前列腺孤立性纤维瘤。排除禁忌证后,行腹腔镜前列腺癌根治术并膀胱颈尿道吻合术。手术历时3小时15分钟完成,术中出血约100毫升。术后对切除肿瘤进行检查,见一巨大球形肿物,大小约11 cm×7.5 cm×6 cm,净重223克。术后病理提示前列腺孤立性纤维瘤(中危型)。术后5天拔除腹腔引流管,术后1周拔除导尿管。患者夜间控尿良好,无尿失禁,但白天偶有漏尿,总体治疗效果满意。术后随访发现患者控尿良好,无肿瘤复发或转移迹象。对于重量超过200克的大前列腺肿瘤,腹腔镜前列腺癌根治术往往具有挑战性,需要术者具备丰富的腹腔镜手术经验,对前列腺解剖结构有充分了解,且手术团队密切配合,才能实现满意的肿瘤学控制和泌尿系统功能保护。