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[320例连续患者盆腔淋巴结清扫术和根治性前列腺切除术的围手术期和术后并发症]

[Perioperative and postoperative complications of pelvic lymphadenectomy and radical prostatectomy in 320 consecutive patients].

作者信息

Hammerer P, Hübner D, Gonnermann D, Huland H

机构信息

Urologische Universitätsklinik, Hamburg-Eppendorf.

出版信息

Urologe A. 1995 Jul;34(4):334-42.

PMID:7545846
Abstract

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.

摘要

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。

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