新辅助内分泌治疗高危前列腺癌后机器人辅助腹腔镜根治术的临床效果分析  

Clinical analysis of neo-adjuvant hormone therapy followed by robot-assisted laparoscopic prostatectomy in the treatment of high-risk prostate cancer

作　　者：吕东[1] 王东[1] 刘竟[1] 熊玮[1] 邱明星[1] 

机构地区：[1]四川省医学科学院,四川省人民医院泌尿外科,成都610072

出　　处：《临床泌尿外科杂志》2015年第12期1086-1088,共3页Journal of Clinical Urology

摘　　要：目的：探讨先行新辅助内分泌治疗（NHT）后行机器人辅助腹腔镜根治术（RALP）治疗高危前列腺癌的可行性及效果。方法：收集2014年5月-2015年5月我院先行NHT后行RALP的21例高危前列腺癌患者的临床资料,术前病检诊断明确,完成Gleason评分,行MRI增强扫描完成临床分期,行骨扫描及相关辅助检查排除远处转移,术前辅助内分泌治疗3-9个月控制PSA〈4μg/L后行RALP。术后观察患者排尿情况及PSA控制情况等。结果：大部分患者手术时间为3-5h。无输血、无直肠穿孔患者,术后1-2周拔除尿管,术后3-6个月均能自行控尿。术后4例病检切缘阳性,术后1-3个月复查PSA〈0.2μg/L。结论：高危前列腺癌患者经内分泌治疗后行PALP是安全可行的,可提高患者生活质量,控制远处转移的时间,但术前需充分评估风险及并发症情况。Objective： To discuss the feasibility and effect of neo-ad）uvant hormone therapy （NHT） followed by robot-assisted laparoscopic prostatectomy （RALP） in the treatment of high-risk prostate cancer. Method： We collected the clinical data of 21 cases of high-risk prostate cancer undergoing robotic assisted laparoscopic prosta-tectomy from May 2014 to May 2015. After confirming the preoperative pathological diagnosis, we completed Gl- eason grading and clinical staging in order to eliminate distant metastasis. Then PSA was controlled less than 4 μg/L after NHT. RALP followed shortly. The urination and PSA control conditions were observed postoperatively. Result： Operation time was 3-5 hours without blood transfusion and rectal perforation. Urinary tube was pulled out after 1-2 weeks of surgery, and all patients experienced good urinary continence after 3-6 months of surgery. The positive surgical margins （PSMs） occurred in four cases. The PSA level was below 0.2 μg/L after 1-3 months of surgery. Conclusion： RALP is a feasible approach to patients with high-risk prostate cancer after NHT. The procedure can improve the patients＇ life quality and delay the progression of distant metastasis. However, it is necessary to assess the risks and complications preoperatively.

关 键 词：新辅助内分泌治疗 高危前列腺癌 前列腺癌根治术 机器人 

分 类 号：R737.25[医药卫生—肿瘤]