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Revista mexicana de urologia Pub Date : 2015-11-01 DOI:10.1016/j.uromx.2015.09.001

S. Collura-Merlier, C. Reyes-Utrera, J.O. Herrera-Cáceres, J.M. Ochoa-López, J.A. Rivera-Ramírez, H. Sandoval-Barba, B. Gabilondo-Pliego

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引用次数: 0

摘要

背景:前列腺特异性抗原筛查的时代使得局限性前列腺癌的发病率增加。根治性手术是治疗候选者的金标准。目的描述三级保健转诊中心腹腔镜根治性前列腺切除术(LRP)的初步经验。材料与方法回顾性分析2013年1月至2015年6月期间行根治性前列腺切除术的患者。11名接受LRP手术的患者都是由同一位外科医生进行的，他们被纳入了研究。统计变量、合并症、术前、术中、术后变量进行分析。生化复发和手术切缘是评估的肿瘤变量。使用SPSS®version 20统计软件包进行描述性统计，进行频率、均值加标准差、中位数和极差分析。结果患者平均年龄为62.7岁，标准差为±7.3。大多数手术前病例是低风险的。考虑到33%的患者在LRP后被归为高风险，我们观察到手术前分期不足的趋势。随访时间8个月(±3.1)。为方便外科医生行膀胱输尿管吻合术，将两例腹腔镜手术改为膀胱输尿管吻合术。出血量、手术时间和住院时间分别为380毫升(240- 2500)、300分钟(105-615)和4天(3-10)。输注率为18%，平均使用时间为7.9天(6 ~ 9.7天)。所有病例均行双侧神经保留手术。术后1个月尿失禁率为72.7%，随访3个月至1年有改善趋势。55%的病例勃起功能得以保留，阳性边缘率为45%。在LRP后一个月，64%的病例检测不到前列腺特异性抗原。36%的患者在术后一个月达到了所谓的三合一结果，18%的患者报告了与术后并发症有关的发生率。结论介绍了我院LRP治疗的初步经验。LRP似乎是一种安全的技术，具有可接受的功能和肿瘤结果。我们是第一个必须更新的系列，因为学习曲线越来越接近最终平台。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Experiencia inicial en prostatectomía radical laparoscópica

Background

The era of prostate-specific antigen screening has produced an increase in the incidence of localized prostate cancer. Radical surgery is the gold standard for patients that are candidates for curative tratment.

Aim

To describe the initial experience with laparoscopic radical prostatectomy (LRP) at a tertiary care referral center.

Material and method

The cohort of patients that underwent radical prostatectomy within the time frame of January 2013 to June 2015 was reviewed. Eleven patients that underwent LRP, all operated on by the same surgeon, were included in the study. Demographic variables, comorbidities, and preoperative, intraoperative, and postoperative variables were analyzed. Biochemical recurrence and surgical margins were the oncologic variables evaluated. Descriptive statistics using the SPSS® version 20 statistical software package were carried out, performing frequency, means plus standard deviation, and median with range analyses.

Results

The mean age of the patients was 62.7 years with a standard deviation of ± 7.3. The majority of the presurgical cases were low-risk. A presurgical understaging trend was observed, given that 33% of patients were classified as high-risk after LRP. Follow-up time was 8 months (± 3.1). Two laparoscopic surgeries were converted for the surgeon's convenience to perform urethrovesical anastomosis. Blood loss, surgery duration, and hospital stay means were 380 ml (240-2,500), 300 min (105-615), and 4 days (3-10), respectively. The transfusion rate was 18% and the mean time with transurethral catheter was 7.9 days (6-9.7). Bilateral nerve-sparing surgery was performed in 100% of the cases. Urinary continence was achieved in 72.7% of the cases at one month after surgery, with an improvement trend from the third month to one year of follow-up. Erectile function was preserved in 55% of the cases and the positive margin rate was 45%. Prostate-specific antigen was undetectable at one month after LRP in 64% of the cases. The so-called trifecta outcome was met at one month after surgery in 36% of the patients and an incidence of 18% was reported in relation to postoperative complications.

Conclusions

We presented the initial experience with LRP at our hospital. LRP appears to be a safe technique with acceptable functional and oncologic results. Ours is a first series that must be updated as the learning curve moves closer to reaching its final plateau.

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来源期刊

Revista mexicana de urologia Medicine-Urology

CiteScore

0.20

自引率

0.00%

发文量

期刊介绍： Revista Mexicana de Urología (RMU) [Mexican Journal of Urology] (ISSN: 0185-4542 / ISSN electronic: 2007-4085) is bimonthly publication that disseminates research by academicians and professionals of the international medical community interested in urological subjects, in the format of original articles, clinical cases, review articles brief communications and letters to the editor. Owing to its nature, it is publication with international scope that disseminates contributions in Spanish and English that are rigorously reviewed by peers under the double blind modality. Neither journalistic documents nor those that lack rigorous medical or scientific support are suitable for publication.