北京大学学报(医学版) ›› 2014, Vol. 46 ›› Issue (4): 532-536.

• 论著 • 上一篇    下一篇

前列腺穿刺活检术后间隔时间对腹腔镜前列腺癌根治术的影响(附专家点评)

李清1,肖博2,刘士军1△,徐涛1,王晓峰1   

  1. (1. 北京大学人民医院泌尿外科,北京100044; 2. 北京大学国际医院泌尿外科,北京102206)
  • 出版日期:2014-08-18 发布日期:2014-08-18

Effects of interval time between prostate biopsy and surgery on laparoscopic radical prostatectomy

LI Qing1, XIAO Bo2, LIU Shi-jun1△, XU Tao1, WANG Xiao-feng1   

  1. (1. Department of Urology, Peking University People’s Hospital, Beijing 100044, China; 2. Department of Urology, Peking University International Hospital, Beijing 102206, China)
  • Online:2014-08-18 Published:2014-08-18

摘要: 目的:探讨前列腺穿刺活检术后与腹腔镜前列腺癌根治术之间的时间间隔长短对手术难易程度及效果的影响。方法:回顾性分析2011年6月至2013年12月于北京大学人民医院泌尿外科行腹腔镜前列腺癌根治术的患者89例,以6周为界,将患者按穿刺术后间隔时间长短分为2组:IT<6周组平均间隔时间3.1周(1.5~4.4周),IT≥6周组平均间隔时间7.6周(6.0~16.2周)。患者平均年龄67岁(57~78岁), 术前平均前列腺特异抗原(prostate specific antigen,PSA)15.4 μg/L(5.2~72.0 μg/L),平均前列腺体积55 mL(42~89 mL)。评估患者手术时间、术中出血量、切缘阳性率、术后住院时间等相关围手术期指标。结果:所有患者均成功接受手术,平均手术时间150 min(110~242 min),平均出血量约230 mL(100~750 mL),术后切缘阳性率为18%,术后3个月控尿率为100%。随访中未见临床复发患者。两组患者年龄、术前PSA、Gleason评分及前列腺体积差异无统计学意义(P>0.05),且两组患者在手术时间、术中出血量、术后切缘阳性率、术后住院时间及术后3个月控尿率方面差异无统计学意义(P>0.05)。结论:前列腺穿刺活检术后与腹腔镜根治术之间的时间间隔长短并非是影响手术难易程度及效果的因素,其对患者术后长期生存及复发率的影响尚待进一步观察。

关键词: 前列腺肿瘤, 活组织检查, 针吸, 前列腺切除术, 腹腔镜检查, 治疗时间

Abstract: Objective:
To investigate the length of interval time between biopsy and laparascopic radical prostatectomy in difficulty and effects of surgery. Methods: We retrospectively analyzed 89 cases of laparascopic radical prostatectomy from June 2011 to September 2013. The patients were divided into two groups according to the interval time of 6 weeks. The mean interval time was 3.1 weeks (ranging from 1.5 to 4.4 weeks) in group IT<6 weeks and 4.4 weeks (ranging from 6.0 to 16.2 weeks) in group IT≥6 weeks. The mean age was 67 years (ranging from 57 to 78 years). The PSA level was 15.4 μg/L (ranging from 5.2 to 72.0). The prostate volume was 55 mL (ranging from 42 to 89 mL). The parameters, such as operation duration, blood loss, positive surgical margin rate, incharge time postoperation, were evaluated. Results: All the surgeries went successfully. The average operation duration was 150 min (ranging from 110 to 242 min), and the blood loss was 230 mL (ranging from 100 to 750 mL). The positive surgical margin rate was 18% and the urinary continence rate was 100% at 3 months after operation. The clinical recurrence was not found during the followup. No significant difference was found between the groups in the patients’ age, preoperative PSA, Gleason score and prostate volume (P>0.05). No statistical significance existed in the operation time, blood loss, positive margin rate, postoperative hospital stay, urinary continence rate at 3 months after operation, postoperative differences of clinical recurrence rates. Conclusion: The length of interval time between prostate biopsy and laparascopic radical prostatectomy does not influence the difficulty and effect in the early stage, and the long time survival and recurrent rate need further observation.

Key words: Prostatic neoplasms, Biopsy, needle, Prostatectomy, Laparoscopy, Time-to-treatment

[1] 邢念增,王明帅,杨飞亚,尹路,韩苏军. 前列腺免活检创新理念的临床实践及其应用前景[J]. 北京大学学报(医学版), 2024, 56(4): 565-566.
[2] 田宇轩,阮明健,刘毅,李德润,吴静云,沈棋,范宇,金杰. 双参数MRI改良PI-RADS评分4分和5分病灶的最大径对临床有意义前列腺癌的预测效果[J]. 北京大学学报(医学版), 2024, 56(4): 567-574.
[3] 姚凯烽,阮明健,李德润,田宇轩,陈宇珂,范宇,刘毅. 靶向穿刺联合区域系统穿刺对PI-RADS 4~5分患者的前列腺癌诊断效能[J]. 北京大学学报(医学版), 2024, 56(4): 575-581.
[4] 欧俊永,倪坤明,马潞林,王国良,颜野,杨斌,李庚午,宋昊东,陆敏,叶剑飞,张树栋. 肌层浸润性膀胱癌合并中高危前列腺癌患者的预后因素[J]. 北京大学学报(医学版), 2024, 56(4): 582-588.
[5] 薛蔚,董樑,钱宏阳,费笑晨. 前列腺癌新辅助治疗与辅助治疗的现状及进展[J]. 北京大学学报(医学版), 2023, 55(5): 775-780.
[6] 刘毅,袁昌巍,吴静云,沈棋,肖江喜,赵峥,王霄英,李学松,何志嵩,周利群. 靶向穿刺+6针系统穿刺对PI-RADS 5分患者的前列腺癌诊断效能[J]. 北京大学学报(医学版), 2023, 55(5): 812-817.
[7] 毛海,张帆,张展奕,颜野,郝一昌,黄毅,马潞林,褚红玲,张树栋. 基于MRI前列腺腺体相关参数构建腹腔镜前列腺癌术后尿失禁的预测模型[J]. 北京大学学报(医学版), 2023, 55(5): 818-824.
[8] 邱敏,宗有龙,王滨帅,杨斌,徐楚潇,孙争辉,陆敏,赵磊,卢剑,刘承,田晓军,马潞林. 腹腔镜肾部分切除术治疗中高复杂程度肾肿瘤的效果[J]. 北京大学学报(医学版), 2023, 55(5): 833-837.
[9] 袁昌巍,李德润,李志华,刘毅,山刚志,李学松,周利群. 多参数磁共振成像中动态对比增强状态在诊断PI-RADS 4分前列腺癌中的应用[J]. 北京大学学报(医学版), 2023, 55(5): 838-842.
[10] 张展奕,张帆,颜野,曹财广,李长剑,邓绍晖,孙悦皓,黄天亮,管允鹤,李楠,陆敏,胡振华,张树栋. 近红外荧光靶向探针用于前列腺神经血管束术中成像[J]. 北京大学学报(医学版), 2023, 55(5): 843-850.
[11] 刘慧丽,吕彦函,王晓晓,李民. 老年患者腹腔镜泌尿系肿瘤根治术后慢性疼痛的影响因素[J]. 北京大学学报(医学版), 2023, 55(5): 851-856.
[12] 田聪,刘军,杨波,乔佳佳,黄晓波,许清泉. 经皮肾镜取石术中异常肾盂黏膜活检结果分析[J]. 北京大学学报(医学版), 2023, 55(5): 948-952.
[13] 许素环,王蓓蓓,庞秋颖,钟丽君,丁炎明,黄燕波,车新艳. 等体温膀胱冲洗对经尿道前列腺电切术患者干预效果的meta分析[J]. 北京大学学报(医学版), 2023, 55(4): 676-683.
[14] 郑丹枫,李君禹,李佳曦,张英爽,钟延丰,于淼. 青少年特发性脊柱侧凸椎旁肌的病理特征[J]. 北京大学学报(医学版), 2023, 55(2): 283-291.
[15] 张铃福,侯纯升,徐智,王立新,凌晓锋,王港,崔龙,修典荣. 腹腔镜下经胆囊管胆管引流联合胆总管探查取石术治疗复杂胆管结石的临床效果[J]. 北京大学学报(医学版), 2022, 54(6): 1185-1189.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!