Evaluation of operative complications related to laparoscopic radical prostatectomy
Evaluation of operative complications related to laparoscopic radical prostatectomy
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DOI：
10.1111/j.1442-2042.2007.01964.x
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发表时间：
2008-03-01
影响因子：
2.6
通讯作者：
Kohri, Kenjiro
中科院分区：
文献类型：
--
作者：
Tozawa, Keiichi;Hashimoto, Yoshihiro;Kohri, Kenjiro
在这十年中，出现了许多治疗局限性前列腺癌的替代方案，例如近距离放射治疗、调强放射治疗、高强度聚焦超声和耻骨后根治性前列腺切除术。在这项回顾性研究中，我们仅回顾了本机构腹腔镜根治性前列腺切除术（LRP）相关并发症的病例，并评估了该手术是否为微创手术。2000年8月至2006年12月期间，本机构共有160名患者接受了LRP作为临床局限性前列腺癌的最终治疗。我们不仅分析了并发症，还分析了手术时间和失血量，以明确 LRP 的适应症。主要并发症被定义为需要手术干预（包括腹腔镜修复）的并发症。 6名患者（3.75%）共发生9项主要并发症（5.63%）。在Cox回归分析中，估计失血量（P = 0.0069）和新辅助激素治疗（P = 0.0019）是LRP手术时间长（> 6小时）的显着预测因素。本研究中LRP的适应症是未接受新辅助激素治疗的T1或T2期局限性前列腺癌。我们的结论是，LRP 的手术和术后发病率较低，并且 LRP 可以由经验丰富的团队常规进行。
In this decade, there have emerged many alternatives for the therapy of localized prostate cancer, such as brachytherapy, intensity modulated radiation therapy, high intensity focused ultrasound, and retropubic radical prostatectomy. In this retrospective study, we reviewed cases of complications related to laparoscopic radical prostatectomy (LRP) from our institution only, and we evaluated whether this procedure was minimally invasive or not.Between August 2000 and December 2006, a total of 160 patients in our institution underwent LRP as the definitive treatment for clinically localized prostate cancer. We analyzed not only the complications but also the operative time and blood loss to clarify the indications of LRP.Major complications were defined as those requiring surgical intervention including laparoscopic repair. A total of nine major complications (5.63%) occurred in six patients (3.75%). In a Cox regression analysis, the estimated blood loss (P = 0.0069) and neoadjuvant hormonal therapy (P = 0.0019) were significant predictors of long operative time (> 6 h) of LRP.The indication of LRP in this study was localized prostate cancer at the T1 or T2 stage for which neoadjuvant hormonal therapy had not been administered. We concluded that the operative and postoperative morbidities of LRP are low and that LRP can be routinely carried out by an experienced team.