Vordos D, Ravery V, Toublanc M, Boccon-Gibod L, Delmas V, Boccon-Gibod L
Service d'Urologie, Hôpital Bichat, Paris, France.
Prog Urol. 1998 Apr;8(2):232-9.
To compare positive resection margin rates in tumour tissue and healthy tissue according to whether total prostatectomy for cancer is performed via a retropubic or transperineal approach.
This retrospective, non-randomized study was based on 94 patients suffering from clinically localized cancer (T1-T2) of the prostate operated either via a retropubic (46: group 1) or perineal (48: group II) approach. All slides were reviewed by two pathologists not informed about the clinical course. The frequency of tumour margins associated with extracapsular invasion, capsular incision, without extracapsular extension of the tumour, and finally the incidence of capsular incisions exposing tumour tissue, were determined.
While the number of positive resection margins was equivalent in the two groups (61% for group I versus 56% for group II), it was higher in the perineal group (43% versus 29%, p < 0.05) when the tumour was confined to the gland (pT2). A higher incidence of resection margins in healthy tissue was also observed in group II (90% versus 37%).
Transperitoneal prostatectomy is associated with a higher incidence of resection margins in tumour tissue in patients with prostate-confined cancer. Analysis of the resection margins in healthy tissue suggests that the surgical incision is a predisposing factor to their creation.
根据前列腺癌根治术是经耻骨后途径还是经会阴途径进行，比较肿瘤组织和健康组织的阳性切缘率。
这项回顾性、非随机研究基于94例患有临床局限性前列腺癌（T1 - T2）的患者，他们分别通过耻骨后途径（46例：第一组）或会阴途径（48例：第二组）进行手术。所有切片均由两名不了解临床病程的病理学家进行复查。确定与包膜外侵犯、包膜切开、肿瘤无包膜外扩展相关的肿瘤切缘频率，以及最终暴露肿瘤组织的包膜切开发生率。
虽然两组的阳性切缘数量相当（第一组为61%，第二组为56%），但当肿瘤局限于腺体（pT2）时，会阴组的阳性切缘率更高（43%对29%，p < 0.05）。第二组健康组织中的切缘发生率也更高（90%对37%）。
经耻骨后前列腺切除术与前列腺局限性癌患者肿瘤组织中切缘发生率较高有关。对健康组织切缘的分析表明，手术切口是导致切缘出现的一个诱发因素。
