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Initial Experience of Open Radical Retropubic Prostatecomy With 5 Cases

机译:根治性开放性耻骨后前列腺癌5例临床研究

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Background: Radical prostatectomy is the best treatment option for clinically localized prostate cancer. But oncological as well as functional outcomes of this procedure including incontinence and erectile dysfunction are a big challenge for the surgeon.Objectives: This paper has focused on our initial experiences of oncological and functional outcomes of open radical retropubic prostatectomy.Materials and methods: Total five cases underwent open radical retropubic prostatectomy between January'2016 to October' 2017. All patients had clinically organ confined prostatic adenocarcinoma. Open radical retropubic prostatectomy with bilateral pelvic lymph node dissection was done through a lower midline incision. We observed the surgical experiences and assess the oncological and functional outcomes postoperatively.Results: The median age (range) of patients at diagnosis was 63 (56-72) years. The median Gleason sum (range) was 7 (6-9) and mean pretreatment PSA was 16.2±5.4 ng/ml. There was no perioperative mortality and no major complications in immediate postoperative period. Final pathological specimen shows negative surgical margin in all cases but one patient has positive unilateral lymph nodes. One patient achieved continence within 3 months; three patients achieved continence at 6 months, one patient after one year. Two patients had satisfactory erection at 6 months; onepatients are at 9 months, and two patients could not gain erection after one year.Conclusion: Though open radical retropubic prostatectomy is tough procedure due to its difficult access to the surgical field. Oncological and functional outcome is totally depending on the skill of the surgical team.
机译:背景:根治性前列腺切除术是临床上局限性前列腺癌的最佳治疗选择。但是,该手术的肿瘤学和功能结局,包括失禁和勃起功能障碍,是外科医生面临的一大挑战。目的:本文重点研究了我们的开放性耻骨后前列腺切除术的肿瘤学和功能结局的初步经验。病例在2016年1月至2017年10月之间进行了根治性耻骨后根治性前列腺切除术。所有患者均患有临床器官受限的前列腺腺癌。通过下中线切口进行双侧盆腔淋巴结清扫术的耻骨后根治性前列腺切除术。我们观察了手术经验并评估了术后的肿瘤和功能结局。结果:诊断时患者的中位年龄(范围)为63(56-72)岁。中位格里森总和(范围)为7(6-9),平均预处理PSA为16.2±5.4 ng / ml。术后即刻无围手术期死亡,无重大并发症。最终病理标本显示所有病例的手术切缘阴性,但一名患者的单侧淋巴结阳性。一名患者在3个月内达到节制; 3例患者在6个月时达到节制,一年后达到1例。 2例患者在6个月时勃起令人满意;结论:尽管根治性前列腺癌根治性切除术难以进入手术区域,但手术难度较大,因此单例患者在9个月时就已经康复,而2名患者则在一年后无法勃起。肿瘤学和功能结果完全取决于手术团队的技能。

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