Ruiz Quijano R A, Martorell Vincenty E
Bol Asoc Med P R. 1995 Jul-Sep;87(7-9):130-4.
Radical prostatectomy has become the gold standard treatment for localized prostate cancer. With the introduction of Laparoscopy Lymphadenectomy for Staging of Prostate Cancer in 1991, interest in the perineal approach to radical prostatectomy has been renewed. Historically, the perineal approach has proven to be less morbid than the retropubic counterpart. Herein, the authors report their experience with 98 male patients with clinically localized T2B (or less) Cancer of the Prostate who underwent Laparoscopic Lymphadenectomy of which 83, subsequently, had a radical perineal prostatectomy. The mean follow up of this group of patients was 16.5 months. Clinicopathological results are discussed and compared with the results of radical retropubic prostatectomy in the literature.
(1) laparoscopic lymphadenectomy with radical perineal prostatectomy are less morbid, with a faster recovery rate than the standard radical retropubic prostatectomy approach. (2) as better non-surgical methods evolve in predicting the status of the pelvic lymph nodes, reserving laparoscopic lymphadenectomy for patients with high risk of developing lymph nodes' metastasis, the perineal prostatectomy and laparoscopic lymph node dissection are becoming the state of the art treatment in patients with localized prostate cancer.
根治性前列腺切除术已成为局限性前列腺癌的金标准治疗方法。随着1991年腹腔镜前列腺癌分期淋巴结切除术的引入，人们对经会阴途径根治性前列腺切除术的兴趣得以重新燃起。从历史上看，经会阴途径已被证明比耻骨后途径的并发症更少。在此，作者报告了他们对98例临床局限性T2B期（或更低分期）前列腺癌男性患者的经验，这些患者接受了腹腔镜淋巴结切除术，其中83例随后接受了根治性经会阴前列腺切除术。这组患者的平均随访时间为16.5个月。对临床病理结果进行了讨论，并与文献中根治性耻骨后前列腺切除术的结果进行了比较。
（1）腹腔镜淋巴结切除术联合根治性经会阴前列腺切除术的并发症更少，恢复速度比标准根治性耻骨后前列腺切除术更快。（2）随着在预测盆腔淋巴结状态方面出现更好的非手术方法，将腹腔镜淋巴结切除术保留给有发生淋巴结转移高风险的患者，经会阴前列腺切除术和腹腔镜淋巴结清扫术正成为局限性前列腺癌患者的先进治疗方法。
