中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2011年
9期
588-590
,共3页
连惠波%汪唯%杨荣%屈峰%张古田%甘卫东%李笑弓%曾令奇%郭宏骞
連惠波%汪唯%楊榮%屈峰%張古田%甘衛東%李笑弓%曾令奇%郭宏鶱
련혜파%왕유%양영%굴봉%장고전%감위동%리소궁%증령기%곽굉건
前列腺肿瘤%癌%冷冻外科手术
前列腺腫瘤%癌%冷凍外科手術
전렬선종류%암%냉동외과수술
Prostatic neoplasms%Carcinoma%Cryosurgery
目的 评价冷冻疗法治疗局限性单病灶前列腺癌的近期疗效及安全性。 方法 局限性单病灶前列腺癌患者12例，均经穿刺活检证实。术前PSA 4.2～14.9 ng/ml，平均9.7 ng/ml。Gleason评分5分3例，6分5例，7分4例。临床分期T1c期8例、T2a期4例。均行超声引导下经会阴前列腺局灶冷冻治疗。术后1年内每3个月、以后每6个月复查PSA。PSA最低值≥1.0 ng/ml或PSA达最低值后上升＞2.0 ng/ml者再次行前列腺穿刺活检排除肿瘤复发。 结果 12例手术顺利，手术时间( 82±26) min，均未输血。术后住院(5±2)d。拔除尿管后，12例控尿均满意。术前有勃起功能者10例，术后仍保持勃起功能者8例。12例随访12 ～ 30个月，平均23个月。术后PSA最低值0.1～6.8 ng/ml，平均2.2 ng/ml，其中＜1.0 ng/ml者9例。术后PSA异常行前列腺穿刺活检4例，阴性3例，冷冻对侧腺体活检阳性1例。 结论 超声引导下经会阴前列腺局灶冷冻治疗安全有效、并发症少，可用于局限性单病灶前列腺癌患者，远期疗效尚需进一步观察。
目的 評價冷凍療法治療跼限性單病竈前列腺癌的近期療效及安全性。 方法 跼限性單病竈前列腺癌患者12例，均經穿刺活檢證實。術前PSA 4.2～14.9 ng/ml，平均9.7 ng/ml。Gleason評分5分3例，6分5例，7分4例。臨床分期T1c期8例、T2a期4例。均行超聲引導下經會陰前列腺跼竈冷凍治療。術後1年內每3箇月、以後每6箇月複查PSA。PSA最低值≥1.0 ng/ml或PSA達最低值後上升＞2.0 ng/ml者再次行前列腺穿刺活檢排除腫瘤複髮。 結果 12例手術順利，手術時間( 82±26) min，均未輸血。術後住院(5±2)d。拔除尿管後，12例控尿均滿意。術前有勃起功能者10例，術後仍保持勃起功能者8例。12例隨訪12 ～ 30箇月，平均23箇月。術後PSA最低值0.1～6.8 ng/ml，平均2.2 ng/ml，其中＜1.0 ng/ml者9例。術後PSA異常行前列腺穿刺活檢4例，陰性3例，冷凍對側腺體活檢暘性1例。 結論 超聲引導下經會陰前列腺跼竈冷凍治療安全有效、併髮癥少，可用于跼限性單病竈前列腺癌患者，遠期療效尚需進一步觀察。
목적 평개냉동요법치료국한성단병조전렬선암적근기료효급안전성。 방법 국한성단병조전렬선암환자12례，균경천자활검증실。술전PSA 4.2～14.9 ng/ml，평균9.7 ng/ml。Gleason평분5분3례，6분5례，7분4례。림상분기T1c기8례、T2a기4례。균행초성인도하경회음전렬선국조냉동치료。술후1년내매3개월、이후매6개월복사PSA。PSA최저치≥1.0 ng/ml혹PSA체최저치후상승＞2.0 ng/ml자재차행전렬선천자활검배제종류복발。 결과 12례수술순리，수술시간( 82±26) min，균미수혈。술후주원(5±2)d。발제뇨관후，12례공뇨균만의。술전유발기공능자10례，술후잉보지발기공능자8례。12례수방12 ～ 30개월，평균23개월。술후PSA최저치0.1～6.8 ng/ml，평균2.2 ng/ml，기중＜1.0 ng/ml자9례。술후PSA이상행전렬선천자활검4례，음성3례，냉동대측선체활검양성1례。 결론 초성인도하경회음전렬선국조냉동치료안전유효、병발증소，가용우국한성단병조전렬선암환자，원기료효상수진일보관찰。
Objective To evaluate term efficacy of focal cryoablation for localized single lesion prostate cancer and the protection of erectile function.Methods From June 2008 to December 2009, 12 patients with localized single lesion prostate cancer were treated with focal cryoablation. All diagnoses were confirmed by transrectal ultrasound-guided prostatic biopsy. The mean Gleason score was ≤ 7; three cases had a Gleason score of 5, five cases a score of 6, and four cases a score of 7. The average preoperative value of PSA was 9.7 ng/ml ( 4.2 - 14.9 ng/ml ). The PSA level was obtained every three months for the first year and then every six months thereafter. Patients with a PSA nadir greater than 1.0 ng/ml or if the PSA nadir increased more than 2 ng/ml underwent repeat biopsy to exclude tumor recurrence.Results The mean operative time was (82 ±26) minutes. The mean postoperative hospital stay was (5 ± 2) days. After catheter removal, all 12 cases had good continence and 10 had erectile function before surgery. Of the 10 patients, eight had erectile function after surgery. The follow - up ranged from 12 to 30 months ( mean 23 ).The lowest average serum PSA nadir was 2.2 ng/ml, nine patients had a minimum PSA nadir of less than 1.0 ng/ml and three had a minimum PSA nadir of more than 1.0 ng/ml. Four patients underwent repeat biopsy after abnormal PSA, and prostate cancer was detected in the contralateral gland in one patient.Conclusions Ultrasound-guided transperineal focal cryoablation is a safe and effective treatment with few complications for localized single lesion prostate cancer. Additional studies with longer follow-up are necessary for long-term efficacy.
