摘要
目的探讨前列腺动脉栓塞联合腹腔镜前列腺癌根治术治疗大体积前列腺癌(>80 g)的临床意义。方法金华市中心医院自2014年1月—2018年10月收治32例大体积前列腺癌患者。前列腺穿刺后2个月直接行腹腔镜前列腺癌根治术16例(A组),其中T2b期10例,T2c期6例,年龄65～79岁,中位年龄73岁。前列腺穿刺后先行前列腺动脉栓塞术,2个月后再行腹腔镜前列腺癌根治术16例(B组),其中T2b期9例,T2c期7例,年龄67～80岁,中位年龄72岁。比较2组患者的手术时间、术中出血量、术后留置导尿时间、术后住院时间及术后并发症等指标。结果 32例患者均顺利完成手术,但大体积前列腺癌行腹腔镜前列腺癌根治术难度较大。B组患者前列腺动脉栓塞术后2个月复查前列腺缩小51.09%～38.45%。B组患者的手术时间、术中出血量、术后留置导尿时间、术后住院时间、术后并发症均明显低于A组,差异均有统计学意义(P<0.05)。32例患者在术后2个月复查血PSA均<0.01 ng/mL。结论前列腺动脉栓塞2个月后行腹腔镜前列腺癌根治术,尝试一种从根本上解决大体积前列腺癌手术困难的方法,降低手术难度,减少术中及术后并发症。
Objective To investigate the clinical significance of prostatic arterial embolization(PAE) combined with laparoscopic radical prostatectomy for prostate cancer patients with large prostate glands(>80 g). Methods Sixteen prostate cancer patients with large prostate glands were treated during January 2014 to October 2018 in Jinhua Municipal Center Hospital. Sixteen cases(group A) which received laparoscopic radical prostatectomy 2 months after prostate biopsy by using B ultrasound guidance. In group A, there were 10 cases of T2 b, 6 cases of T2 c, aged from 65 to 79 years. Sixteen cases(group B) diagnosed with prostate cancer which received laparoscopic radical prostatectomy 2 months after prostatic arterial embolization. In group B, there were 9 cases of T2 b, 7 cases of T2 c, aged from 67 to 80 years. Operating time, amount of bleeding during operation, postoperative indwelling catheterization time, the hospital stay and complications were compared between group A and group B. Results All the 32 cases were operated successfully. Laparoscopic radical prostatectomy in large prostate glands poses a significant challenge to urologists. Two months after PAE, prostate volume decreased for 51.09%-38.45% in group B. In group B, operating time, amount of bleeding during operation, postoperative indwelling catheterization time, the hospital stay and complications were all better than those in group A(P<0.05). Moreover, the results of PSA of all 32 patients decreased to <0.01 ng/mL at postoperative two months. Conclusion For prostate cancer patients with large prostate glands which received laparoscopic radical prostatectomy 2 months after prostatic arterial embolization, it can reduce the difficulty of operation and reduce complications.
作者
孙鹏
吴海啸
郭晓华
胡洋
胡晓钢
朱德胜
SUN Peng;WU Hai-xiao;GUO Xiao-hua(Department of Urology, Jinhua Municipal Center Hospital, Jinhua,Zhejiang 321000, China)
出处
《中华全科医学》
2019年第6期955-958,共4页
Chinese Journal of General Practice
基金
浙江省金华市社会发展类一般科研基金项目(20164003)
浙江省医药卫生科技计划项目(2017RC031)
关键词
前列腺动脉栓塞
前列腺癌
大体积
Prostatic arterial embolization
Prostate cancer
Large volume
