Andriole G L, Smith D S, Rao G, Goodnough L, Catalona W J
Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri 63110.
J Urol. 1994 Nov;152(5 Pt 2):1858-60. doi: 10.1016/s0022-5347(17)32400-x.
Anatomical radical retropubic prostatectomy is commonly performed to treat select patients with clinically localized prostate cancer. Because this recently introduced surgical technique is technically demanding, and since early detection programs have altered the age and stage distribution of men undergoing radical prostatectomy, earlier reports describing complication and death rates from radical prostatectomy may not accurately reflect contemporary experience. A retrospective review of 1,342 radical retropubic prostatectomies performed during a 5-year period showed an early complication rate of 7.4%. The most common complications were thromboembolic (pulmonary embolism) and cardiac (myocardial infarction). Patient age, mode of diagnosis (transurethral resection of the prostate versus needle biopsy) and pathological stage of the tumor did not correlate with the rate of complications. Three patients died in this series (0.2%). This retrospective review shows that contemporary anatomical retropubic radical prostatectomy may be performed with acceptably low early morbidity and mortality rates, and that appropriate selection of chronologically older patients is not associated with significantly greater rates of early complications. These data may be useful in decision analytic models evaluating the role of therapy for patients with early stage prostate cancer.
耻骨后根治性前列腺切除术通常用于治疗部分临床局限性前列腺癌患者。由于这种最近引入的手术技术对技术要求较高，且早期检测项目改变了接受根治性前列腺切除术男性的年龄和分期分布，因此早期描述根治性前列腺切除术并发症和死亡率的报告可能无法准确反映当代的情况。一项对5年内进行的1342例耻骨后根治性前列腺切除术的回顾性研究显示，早期并发症发生率为7.4%。最常见的并发症是血栓栓塞（肺栓塞）和心脏并发症（心肌梗死）。患者年龄、诊断方式（经尿道前列腺切除术与穿刺活检）以及肿瘤的病理分期与并发症发生率无关。该系列中有3例患者死亡（0.2%）。这项回顾性研究表明，当代耻骨后根治性前列腺切除术的早期发病率和死亡率可接受地低，并且按年龄适当选择老年患者与早期并发症发生率显著升高无关。这些数据可能有助于评估早期前列腺癌患者治疗作用的决策分析模型。
