CAJ | 학술논문

目的探索保留尿道括约肌手术技巧在前列腺癌根治术中的应用效果.方法本组80例前列腺癌患者,年龄66岁(范围59~75岁);79例前列腺肿瘤限于T2b期以内,1例T3期;78例因PSA升高行术前经直肠超声波(TRUS)引导下的前列腺穿刺活检,Gleason分级3~7分,另2例为TURP后偶发癌;PSA平均8.5ng/ml(范围2.7~44.5 ng/ml).手术前均无尿失禁情况.手术技巧:处理阴茎背深静脉丛采用集束“8”字缝扎;处理前列腺尖部时紧贴前列腺表面分离,并保留前列腺部尿道0.5~1cm;保留膀胱颈部.结果手术后随访12~48个月,18例生化复发,6例尿失禁.结论尿道外括约肌的保留能够减少前列腺癌根治术后尿失禁的发生.
목적탐색보류뇨도괄약기수술기교재전렬선암근치술중적응용효과.방법본조80례전렬선암환자,년령66세(범위59~75세);79례전렬선종류한우T2b기이내,1례T3기;78례인PSA승고행술전경직장초성파(TRUS)인도하적전렬선천자활검,Gleason분급3~7분,령2례위TURP후우발암;PSA평균8.5ng/ml(범위2.7~44.5 ng/ml).수술전균무뇨실금정황.수술기교:처리음경배심정맥총채용집속“8”자봉찰;처리전렬선첨부시긴첩전렬선표면분리,병보류전렬선부뇨도0.5~1cm;보류방광경부.결과수술후수방12~48개월,18례생화복발,6례뇨실금.결론뇨도외괄약기적보류능구감소전렬선암근치술후뇨실금적발생.
Objective To investigate the effects of sphincter-preserving technique in retro-pubic radical prostatectomy on post-operative urinary continence. Methods Total of 80 patients with prostate cancer were recruited in this study. Their average age was 66 (range from 59 to 75) years and their clinical stage were all within T2b except 1 case in T3. Seventy-eight patients with abnormal PSA values underwent TRUS biopsies, and their Gleason scores ranged from 3 to 7, other 2 patients with normal PSA value were diagnosed as PCa after TURP;Mean PSA value was 8.5ng/ml(range from 2.7 to 44.5 ng/ml).No urinary incontinence was found pre-operatively for all the patients. Operative skills:“Bunching technique”was used in management of dorsal vein complex;Careful dissection was done by sharp dissection closely to the surface of the apex of the prostate and about 0.5 to 1 cm of urethra within the apex was preserved; Preservation of the bladder neck. Results All the patients were followed up 12 to 48 months after prostatectomy. Biochemical recurrence was found in 18 patients and urinary incontinence in 6 patients. Conclusion External urinary sphincter preserving technique in radical retro-pubic prostatectomy can decrease the rate of post-operative urinary incontinence.