Avtor/Urednik		Zupančič, Marko; Vodopija, Nada; Koršič, Ljubo; Kramer, Franc; Pospihalj, Boris
Naslov		Laparoskopska radikalna prostatektomija
Prevedeni naslov		Laparoscopic radical prostatectomy
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 69, št. 5
Leto izdaje		2000
Obseg		str. 329-31
Jezik		slo
Abstrakt		Background. Our purpose was to present our experiences with new method of the radical prostatectomy and to compare our results with published in the literature and also with our classical retropubic radical prostatectomy results. Methods. In the paper, we analyse our 9 patients with mean age 61.1 years, range 55-71, who underwent transabdominal laparoscopic radical prostatectomy between June and November 1999. Laparoscopic procedure was performed entirely in 7 patients, in 2 patients conversion was necessary, one patient we had to reoperate because of rectal wall injury. Preoperative PSA level was between 5.50 and 14.95 ng/ml, estimate clinical stage was T2. Results. The median operating time in 7 complete laparoscopic procedures was 270 minutes, including times for pelvic lymph node dissection performed in 2 cases. All patients were transfused with an average of 1000 ml of packed red cells. Postoperative vesical catheterisation in 7 patients lasted an average of 6.14 days, 2 patients left hospital with the catheter. Median postoperative hospitalisation was 7.7 days. The pathohistological results were as follows: 2 patients (22%) had a T2a cancer, 1 patient (11 %) had a T2b and 6 patients (67%) had a T2c cancer. Gleason score was between 5 and 7. Surgical margins were negative in 7patients (78%). Conclusions. Our results with laparoscopic radical prostatectomy are comparable with those published in the literature. We believe that laparoscopic approach makes possible much more precise dissection and improves the functional results of radical prostatectomy, mostly continence and potency. Regarding well known learning curve in laparoscopic surgery, we are convinced in significant reduction of the operatirag time.
Izvleček		Izhodišča. Namen prispevka je predstaviti naše izkušnje z novo metodo radikalne prostatektomije in jih primerjati z rezultati, ki so objavljeni v strokovni literaturi, ter našimi rezultati pri klasični retropubični radikalni prostatektomiji. Metode. V članku smo analizirali operacijsko zdravljenje pri devetih bolnikih, v starosti od 55 do 71 let in s povprečno starostjo 61,1 leta, ki smo jim v šestih mesecih, v obdobju od junija do novembra 1999, na našem oddelku naredili laparoskopsko radikalno prostatektomijo. Laparoskopski poseg v celoti smo naredili pri sedmih bolnikih, pri dveh je bila potrebna konverzija, to je nadaljevanje operacijskega posega s klasično retropubično metodo. Enega bolnika smo morali zaradi pozno ugotovljene poškodbe debelega črevesa ponovno operirati. Vrednosti serumskega PSA pred operacijskim posegom so bile med 5,50 in 14,95 ng/ml, ocena kliničnega stadija pa T2. Rezultati. Povprečen operacijski čas pri sedmih bolnikih, vključno z dvema, pri katerih smo naredili regionalno limfadenektomijo, je bil 270 minut. Vsi bolniki so prejeli transfuzijo koncentriranih eritrocitov, povprečna izguba krvi je znašala 1000 ml. Urinski kateter po operaciji je 7 bolnikov povprečno nosilo 614 dneva, dva bolnika pa sta bila z urinskim katetrom odpuščena. Povprečna hospitalizacija po operacijskem posegu je znašala 7, 7 dneva. Patohistološki rezultati so bili naslednji: pri dveh bolnikih (22%) je šlo za stadij T2a , en bolnik (11%) je imel T2b, pri šestih bolnikih (67%) pa je šlo za stadij T2c. Gleason score je bil med 5 in 7. Pri sedmih bolnikih (78%) so bili kirurški robovi negativni. Zaključki. Naši rezultati laparoskopske radikalne prostatektomije so primerljivi z rezultati, ki so objavljeni v strokovni literaturi. Menimo, da laparoskopski pristop omogoča natančnejšo preparacijo in izboljšuje funkcionalne rezultate radikalne prostatektomije, še posebej kontinenco in potenco. (Izvleček prekinjen pri 2000 znakih.)
Deskriptorji		PROSTATIC NEOPLASMS PROSTATECTOMY SURGERY, LAPAROSCOPIC TREATMENT OUTCOME