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[根治性前列腺切除术的临床研究]

[A clinical study of radial prostatectomy].

作者信息

Hotta H, Miyao N, Masumori N, Takahashi A, Sasamura K, Kitamura H, Tsukamoto T, Takatsuka K, Adachi H, Takagi Y, Takagi S, Umehara T, Kimura M

机构信息

Department of Urology, Sapporo Medical University School of Medicine, Japan.

出版信息

Nihon Hinyokika Gakkai Zasshi. 1996 Apr;87(4):760-5. doi: 10.5980/jpnjurol1989.87.760.

Abstract

BACKGROUND

The objective of this study is to evaluate the efficacy of radical prostatectomy for patients with organ-confined prostate cancer.

METHODS

From 1990 to 1994, a total of 50 patients with prostate cancer underwent radical retropubic prostatectomy.

RESULTS

Eleven patients were in state A2, 34 in stage B and 5 in stage C according to clinical stage. Extended disease was observed pathologically in 45%, and 59% of patients in clinical stages A2 and B, respectively. Preoperative serum PSA levels were closely correlated with pathological extension of the disease. The disease-free rates for organ-confined disease, extended disease without lymph node metastasis and stage D1 disease were 75% (3 years), 82% (2 years) and 80% (3 years), respectively. Four patients had rectal injuries, and three of these underwent temporary colostomy diversion. Two patients had bladder neck contracture and received internal urethrotomy. Urinary incontinence improved in 60% of patients during the first 6 post-operative and in 90% of patients within 12 post-operative months. Urinary incontinence tended to improve earlier in patients with nerve-sparing than those without it. The erectile capacity in nerve sparing patients recovered good.

CONCLUSION

Our results indicate that radical prostatectomy is a safe and temporarily satisfactory treatment for the patient with organ-confined prostate cancer.

摘要

背景

本研究的目的是评估根治性前列腺切除术对器官局限性前列腺癌患者的疗效。

方法

1990年至1994年,共有50例前列腺癌患者接受了耻骨后根治性前列腺切除术。

结果

根据临床分期,11例患者处于A2期,34例处于B期,5例处于C期。病理观察发现45%的患者存在疾病进展,临床分期为A2期和B期的患者中分别有59%出现疾病进展。术前血清前列腺特异抗原(PSA)水平与疾病的病理进展密切相关。器官局限性疾病、无淋巴结转移的进展期疾病和D1期疾病的无病生存率分别为75%(3年)、82%(2年)和80%(3年)。4例患者发生直肠损伤,其中3例接受了临时结肠造口改道术。2例患者出现膀胱颈挛缩并接受了内尿道切开术。60%的患者在术后6个月内尿失禁有所改善,90%的患者在术后12个月内尿失禁有所改善。保留神经的患者尿失禁改善往往比未保留神经的患者更早。保留神经患者的勃起功能恢复良好。

结论

我们的结果表明,根治性前列腺切除术对于器官局限性前列腺癌患者是一种安全且暂时令人满意的治疗方法。

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