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OBJECTIVE: To sum up the experience in the treatment of prostate cancer found in transurethral resection of the prostate (TURP) by laparoscopic radical prostatectomy (LRP). METHODS: Fourteen patients found with prostate cancer during TURP underwent LRP in our hospital between 2011 and 2016. We reviewed our experience in the treatment and analyzed the clinical and follow-up data. RESULTS: LRP was successfully performed in all the cases at 1ï¼4 months after TURP, with a mean operation time of (113 ± 94) min (80ï¼220 min), a mean blood loss of (188 ± 152) ml (100ï¼500 ml), a mean catheterization time of (11.7 ± 3.7) d (7ï¼16 d), and a median follow-up time of 28 (4ï¼68) months. There were no rectal injuries, conversion to open surgery, or blood transfusion during the operation. Positive surgical margin was found in 1 case, in which the tumor involved the nerve and vessel, and lymphatic fistula occurred in another. Urinary continence was desirable in 13 cases at 12 months after surgery, and no incontinence was observed in the other, which had been followed up for less than 12 months. The patient with positive surgical margin received radiotherapy and endocrine therapy postoperatively and was still alive without pathologic progression. No biochemical or clinical recurrence was found in the other 13 cases. CONCLUSIONS: LRP at 1 month after TURP can provide a proper anatomical plane, make the operation easier, and achieve a satisfactory functional and oncological prognosis for patients with prostate cancer.
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Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Ressecção Transuretral da Próstata , Humanos , Laparoscopia , Masculino , Duração da Cirurgia , Neoplasias da Próstata/patologia , Resultado do Tratamento , Incontinência UrináriaRESUMO
Objective@#To sum up the experience in the treatment of prostate cancer found in transurethral resection of the prostate (TURP) by laparoscopic radical prostatectomy (LRP).@*METHODS@#Fourteen patients found with prostate cancer during TURP underwent LRP in our hospital between 2011 and 2016. We reviewed our experience in the treatment and analyzed the clinical and follow-up data.@*RESULTS@#LRP was successfully performed in all the cases at 1-4 months after TURP, with a mean operation time of (113 ± 94) min (80-220 min), a mean blood loss of (188 ± 152) ml (100-500 ml), a mean catheterization time of (11.7 ± 3.7) d (7-16 d), and a median follow-up time of 28 (4-68) months. There were no rectal injuries, conversion to open surgery, or blood transfusion during the operation. Positive surgical margin was found in 1 case, in which the tumor involved the nerve and vessel, and lymphatic fistula occurred in another. Urinary continence was desirable in 13 cases at 12 months after surgery, and no incontinence was observed in the other, which had been followed up for less than 12 months. The patient with positive surgical margin received radiotherapy and endocrine therapy postoperatively and was still alive without pathologic progression. No biochemical or clinical recurrence was found in the other 13 cases.@*CONCLUSIONS@#LRP at 1 month after TURP can provide a proper anatomical plane, make the operation easier, and achieve a satisfactory functional and oncological prognosis for patients with prostate cancer.
Assuntos
Humanos , Masculino , Laparoscopia , Duração da Cirurgia , Prostatectomia , Métodos , Neoplasias da Próstata , Patologia , Cirurgia Geral , Ressecção Transuretral da Próstata , Resultado do Tratamento , Incontinência UrináriaRESUMO
Objective To compare the clinical effect of 2D and 3D laparoscopic radical prostectomy and summarize surgical experience of laparoscopic radical prostectomy of early prostate cancer.MethodsThe clinical data of 34 cases of prostate cancer treated in our institute from November 2015 to April 2016 were collected and analyzed retrospectively. The patients in observation group (11 cases) were treated by 3D laparoscopic radical prostectomy, while those in control group (23 cases) were given 2D laparoscopic radical prostectomy. The operation time, intraoperative bleeding volume, postoperative drainage time, quantity of drainage fluid within 24 hours postoperatively, indwelling catheter time, hospital time, positive surgical margin rate, potence rate, 30d-urinary continence rate and complications were compared between the two groups.Results All operations were successfully performed. There were no signiifcant differences in operation time, intraoperative bleeding volume, postoperative drainage time, quantity of drainage lfuid within 24 hours postoperatively, indwelling catheter time, hospital time, positive surgical margin rate, potence rate, 30d-urinary continence rate and complications between the two groups (P > 0.05). In observation group, the operation time was (153.52 ± 30.47) min and the potence rate was 50.0 %, 4 cases with uroclepsia (36.4 %), 1 case with urine leakage (9.1 %), no patient had urethral stricture or positive surgical margin, the 30d-urinary continence rate was 72.7 %. In control group, the operation time was (164.73 ± 28.65) min and the potence rate was 38.9 %, 13 cases with uroclepsia (56.5 %), 4 cases with urine leakage (17.4 %), 1 case with urethral stricture (4.3 %), 2 cases with positive surgical margin (8.7 %), 30d-urinary continence rate was 60.9 %.ConclusionLaparoscopic radical prostectomy is a safe, effective and less invasive method for treating early prostate cancer patients. Also 3D laparoscopic radical prostectomy play the similar functional results compared with 2D laparoscopic radical prostectomy, but 3D laparoscopic has the advantage in three dimensions space sense and accurate operation, it is worthy of promoting clinical application.
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Objective To evaluate the application of the transurethral vapor-resection of the prostate(TU- VRP) for bladder outlet obstruction(BOO) in patients with prostate eaneer(PCa). Methods Of 33 patients with BOO. 18 were definitely diagnosed with PCa and after treatment they still had symptoms of BOO;15 cases were di- agnosed with benign prostate hyperplasia(BPH). All patients underwent TUVRP for BOO. Results All cases were successfully done. Postoperative complications included transient urinary ineontinenee in 5 ,and gross hematuria in 9. 27 patients were followed up(10-36 months).8 cases died of PCa,with a mean survival of 31 months.5 cases died of other diseases. After treatment, PSA levels decreased to ( 10.2 ± 6.7) μg/L. The average residual urinary volume (RU) decreased to (39.7 ± 13.9) ml, and the average IPSS was (8.7 ± 1.6 ). Compared with those of preoperation, the differences were statistically significant ( P < 0.05 ). Conelnsion TUVRP is a reliable treatment for prostate cancer with bladder outlet obstruction.
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Objective To evaluate the therapeutic effects of functional reconstructive technique of laparoscopic radical prostatectomy (LRP) for organ confined prostate cancer. Methods From October 2000 to September 2004,54 patients with organ confined prostate cancer (TNM stage of T 1b-T 2) underwent LRP.After completion of the first group of 15 consecutive cases (group A) by Monstouris techniques, the functional reconstructive surgical technique, which is basically composed of anatomical radical prostatectomy,was introduced to LRP in the second group of 39 consecutive cases (group B).These techniques mainly consisted of preservation of urethral and bladder outlet sphincter muscles,reconstruction of bladder neck,and fine anastomosis between urethra and bladder neck with fixation of anterior wall of anastomotic stoma and retropubic vascular complex.The operative time, bleeding volume,complications,continence recovery time and PSA level were comparatively analyzed between the 2 groups. Results All the operations were successful in 54 patients.In group A and group B,the mean operative time was 390 min(range,270-660 min)vs 240 min(range,180-360 min);the mean bleeding volume was 430 ml(range,200-1100 ml) vs 160 ml(100-400 ml);the complication rate was 40% (6/15) vs 13% (5/39) and the continence recovery time was on average 6 months vs 3 months,respectively. There were statistically significant differences in these parameters between the 2 groups (P