Feasibility of antegrade radical prostatectomy for clinically locally advanced prostate cancer: a comparative study with clinically localized disease
Feasibility of antegrade radical prostatectomy for clinically locally advanced prostate cancer: a comparative study with clinically localized disease
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DOI：
10.1111/j.1442-2042.2010.02569.x
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发表时间：
2010-08-01
影响因子：
2.6
通讯作者：
Fukui, Iwao
中科院分区：
文献类型：
--
作者：
Yamamoto, Shinya;Kawakami, Satoru;Fukui, Iwao
目的：探讨临床局部晚期前列腺癌（cLAD）的顺行根治性前列腺切除术与预期广泛切除术（阿普）的术中和术后早期并发症，并与临床局限性前列腺癌（cLD.Methods）的阿普进行比较：1994年3月至2007年6月期间，800例连续日本患者，包括625例cLD和175例cLAD进行阿普和双侧有限淋巴结切除术。比较cLD组和cLAD组术中及术后早期（术后30 d内）并发症等临床病理资料。两组的手术时间和失血量无显著差异。在整个队列中分别观察到11例（1.4%）和123例（15.4%）术中和术后早期并发症。术后早期并发症主要为盆腔血肿、伤口感染、尿潴留、淋巴囊肿或淋巴引流延长。两组之间的整个术中和术后早期并发症无显著差异。大多数的早期术后并发症是minor.Conclusions：阿普的cLAD是技术上可行的，是一种安全的外科手术。如果根治性髂内动脉切除术在未来可以作为cLAD的标准治疗，阿普可能是有价值的多模式治疗的第一步。
Objectives:To investigate intraoperative and early postoperative complications of antegrade radical prostatectomy with intended wide resection (aRP) for clinically locally advanced prostate cancer (cLAD) and to compare with those of aRP for clinically localized prostate cancer (cLD).Methods:Between March 1994 and June 2007, 800 consecutive Japanese patients including 625 with cLD and 175 with cLAD underwent aRP and bilateral limited lymphadenectomy. Clinicopathological data including intraoperative and early postoperative complications (within 30 days after operation) were compared between cLD and cLAD groups.Results:No deaths occurred. Operative time and blood loss did not differ significantly between the groups. Intraoperative and early postoperative complications were observed in 11 (1.4%) and 123 (15.4%) of the entire cohort, respectively. Prevalent early postoperative complications were pelvic hematoma, wound infection, urinary retention and lymphocele or prolonged lymph drainage. There were no significant differences in the entire intraoperative and early postoperative complications between the groups. The majority of the early postoperative complications were minor.Conclusions:aRP for cLAD is technically feasible and a safe surgical procedure. If radical prostatectomy could be established as a standard treatment for cLAD in the future, aRP might be valuable as the first step of multimodal treatments.