Hammerer P, Hübner D, Gonnermann D, Huland H
Urologische Universitätsklinik, Hamburg-Eppendorf.
Urologe A. 1995 Jul;34(4):334-42.
To examine the intra- and postoperative morbidity of radical retropubic prostatectomy we analyzed the first 320 consecutive patients with clinical stages T1b, T2a-c and negative lymph nodes by frozen section. Patient age varied from 42 to 75 years (mean 63.5 years). In 74.7% the estimated blood loss was less than 1500 ml. With a preoperative autologous blood collection program the intraoperative blood requirement for homologous blood units was only 15%. Intraoperative complications included rectal injuries with vesical rectal fistulas in 2.5% and ureteral injuries in 1.6%. Within the perioperative period the mortality rate was 0.9%. At 12 months after surgery 199 of 218 men (90.9%) were continent, 5.1% had minimal urinary incontinence, and only 4.6% had urinary incontinence grade III. Postoperatively, PSA (prostate-specific antigen) decreased to < 0.5% in 90.4% of the patients after radical prostatectomy. At 12 months after operation PSA was < 0.5 ng/ml in 83.4%. We conclude that radical retropubic prostatectomy is a safe procedure for the curative treatment of localized prostate cancer.
为了研究耻骨后根治性前列腺切除术的术中及术后发病率，我们分析了连续320例临床分期为T1b、T2a - c且冰冻切片显示淋巴结阴性的患者。患者年龄在42岁至75岁之间（平均63.5岁）。74.7%的患者估计失血量少于1500毫升。通过术前自体血采集计划，术中对异体血单位的需求仅为15%。术中并发症包括2.5%的直肠损伤伴膀胱直肠瘘和1.6%的输尿管损伤。围手术期死亡率为0.9%。术后12个月时，218名男性中有199名（90.9%）控尿，5.1%有轻度尿失禁，仅有4.6%为Ⅲ级尿失禁。前列腺癌根治术后，90.4%的患者术后前列腺特异性抗原（PSA）降至<0.5%。术后12个月时，83.4%的患者PSA<0.5纳克/毫升。我们得出结论，耻骨后根治性前列腺切除术是治疗局限性前列腺癌的一种安全手术。
