腹腔镜盆腔淋巴结清扫术、腹腔镜辅助精囊游离术以及经会阴前列腺根治切除术与耻骨后前列腺根治切除术治疗前列腺癌的比较

Laparoscopic pelvic lymph node dissection, laparoscopically assisted seminal vesicle mobilization, and total perineal prostatectomy versus radical retropubic prostatectomy for prostate cancer.

作者信息

Teichman J M, Reddy P K, Hulbert J C

机构信息

Department of Urology, University of Minnesota Hospital and Clinic, Minneapolis, USA.

出版信息

Urology. 1995 May;45(5):823-30. doi: 10.1016/S0090-4295(99)80090-9.

DOI:10.1016/S0090-4295(99)80090-9

PMID:7538244

Abstract

OBJECTIVES

The outcomes of patients with prostate cancer who were candidates for radical prostatectomy were compared with patients who underwent either: (1) radical retropubic prostatectomy (RRP); or (2) laparoscopic pelvic lymph node dissection, laparoscopically assisted seminal vesicle mobilization, and total perineal prostatectomy (LN-SV-TPP).

METHODS

The staging, surgical, and early postoperative characteristics of 10 consecutive patients treated by RRP were compared with 12 consecutive patients who underwent LN-SV-TPP.

RESULTS

Patients who underwent LN-SV-TPP versus RRP had respective median blood loss of 450 versus 1250 cc (P = 0.001), median anesthesia time of 330 versus 287.5 minutes (P = 0.05), median surgical time of 237.5 versus 237.5 minutes (P = 0.6), median units transfused of 0 versus 1 (P = 0.05), median time to ambulation of 1 versus 2 days (P = 0.002), median time to oral intake of 1 versus 3.5 days (P < 0.001), median hospital stay of 3 versus 6 days (P < 0.001), and median morphine requirements of 44 versus 119 mg (P < 0.001).

CONCLUSIONS

LN-SV-TPP is less morbid than RRP concerning blood loss, blood transfusions, pain, and postoperative recovery. Compared with LN-SV-TPP, RRP is faster and is particularly indicated for ease of performing a nerve-sparing radical prostatectomy.

摘要

目的

将符合根治性前列腺切除术条件的前列腺癌患者的治疗结果，与接受以下两种手术之一的患者进行比较：（1）耻骨后根治性前列腺切除术（RRP）；或（2）腹腔镜盆腔淋巴结清扫术、腹腔镜辅助精囊游离术和经会阴根治性前列腺切除术（LN-SV-TPP）。

方法

将连续10例接受RRP治疗的患者的分期、手术及术后早期特征，与连续12例接受LN-SV-TPP的患者进行比较。

结果

接受LN-SV-TPP与RRP的患者，术中失血量中位数分别为450 cc和1250 cc（P = 0.001），麻醉时间中位数分别为330分钟和287.5分钟（P = 0.05），手术时间中位数均为237.5分钟（P = 0.6），输血单位中位数分别为0和1（P = 0.05），下床活动时间中位数分别为1天和2天（P = 0.002），恢复经口进食时间中位数分别为1天和3.5天（P < 0.001），住院时间中位数分别为3天和6天（P < 0.001），吗啡需求量中位数分别为44 mg和119 mg（P < 0.001）。