Teichman J M, Reddy P K, Hulbert J C
Department of Urology, University of Minnesota Hospital and Clinic, Minneapolis, USA.
Urology. 1995 May;45(5):823-30. doi: 10.1016/S0090-4295(99)80090-9.
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).
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.
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).
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.
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）。
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。
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）。
在失血、输血、疼痛及术后恢复方面，LN-SV-TPP比RRP的创伤性更小。与LN-SV-TPP相比，RRP速度更快，尤其适用于便于实施保留神经的根治性前列腺切除术。
