Author/Editor     Vodopija, Nado; Ovčak, Zdenka; Zupančič, Marko; Koršič, Ljubo; Kramer, Franc; Krstanoski, Zoran; Parać, Ivan; Kolenc, Alojz; Drinovec, Jože
Title     Laparoscopic radical prostatectomy does not cause significant tissue ischemia
Translated title     Laparoskopska radikalna prostatektomija ne povzroča pomembne ishemične okvare
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 75, št. 12
Publication year     2006
Volume     str. 763-8
Language     eng
Abstract     Background Today, laparoscopic radical prostatectomy is cz commonly used operation with patients suffering from prostatic carcinoma. In contrast to the classic open radical prostatectomy, the laparoscopic approach is more patient-friendly, whereas long-term results are similar with both methods. CO2 which is being insufflated during laparoscopic radical prostatectomy at a pressure of 12-14 mm Hg, could cause ischemic disorder of tissue in operating field. Patients and methods The research group consisted of 44 patients with prostatic carcinoma, coming from the Department of Urology of General Hospital Slovenj Gradec; they were treated with laparoscopic radical prostatectomy, namely the Montsouris technique. The control group however, consisted of 11 patients with prostatic carcinoma from the Department of Urology of the Maribor Teaching Hospital. They were treated with a classic retropubic radicalprostatectomy. Besides clinical data andpathological examinations, patientsfrom both groups were examined for activity of GSH-Px, SOD and CAT enzymes in the venous blood before the operation and immediately after it. After the operation we also took a tissue sample of eachpatientš bladder neckfor immune histochemical and morphometrical examination of open capillary surface. Results Patients of both groups were clinically comparable. Those, treated with the laparoscopic method hacllonger operating time than patients treated with the classic approach (219:140 min.), there was also a lower blood loss (33:542), shorter analgesic therapy (3.2: 6.5 days), shorterperiod of urinary catheterisation (5.3:14.7 days). Patients treated laparoscopically, had no statistically notable change in the activity of GSH-Px, SOD arccl CAT enzymes in the venous blood after the operation in comparison to the activity before the operation. (Abstract truncated at 2000 characters)
Summary     Izhodišča Karcinom prostate je v razvitem svetu najpogostejša maligna bolezen pri moških, starejših od 50 let. Laparoskopska radikalna prostatektomija je danes pogosto uporabljana operacija pri bolnikih s karcinomom prostate. Za razliko od klasične odprte radikalne prostatekomije je laparoskopski pristop za bolnika prijaznejši, dolgoročni izidi pa podobni pri obeh metodah. Plin CO2, ki ga insufliramo med laparoskopsko radikalno prostatektomijo, s tlakom med 12 in 14 mm Hg, bi lahko povzročal ishemične okvare na tkivih v operacijskem področju. Bolniki in metode V prospektivni primerjalni klinični raziskavi smo oblikovali dve skupini bolnikov. V preiskovano skupino je bilo vključenih 44 bolnikov s karcinomom prostate iz Urološkega oddelka Splošne bolnišnice Slovenj Gradec; zdravili smo jih z laparoskopsko radikalno prostatektomijo s tehniko Montsouris. V kontrolno skupino pa je bilo vključenih 11 bolnikov s karcinomom prostate iz Urološkega oddelka Učne bolnišnice Maribor. Ti so bili zdravljeni s klasično retropubično radikalno prostatektomijo. Poleg kliničnih podatkov in patoloških preiskav smo bolnikom v obeh skupinah določali aktivnost encimov GSH-Px, SOD in CAT v venski krvi pred začetkom operacije in neposredno po njej. Prav tako smo vsem bolnikom na koncu operacije vzeli košček tkiva s površine vratu sečnika za imunohistokemično in morfometrično preiskavo površine odprtih kapilar. Rezultati Bolniki preiskovane in kontrolne skupine so si bili med seboj klinično primerljivi. Pri tistih, ki so bili operirani po laparoskopski metodi, je operacija trajala dalj časa (219 ± 43 min.) kot pri klasično operiranih (140 ± 13 min.). Količina izgubljene krvi med operacijo je bila signifikantno manjša pri laparoskopsko operiranih bolnikih (343 ± 265 ml) v primerjavi z bolniki v kontrolni skupini (542 ± 157 ml). (Izvleček skrajšan pri 2000 znakih)
Descriptors     PROSTATECTOMY
LAPAROSCOPY
PROSTATIC NEOPLASMS
ISCHEMIA
GLUTATHIONE PEROXIDASE
SUPEROXIDE DISMUTASE
CATALASE
CAPILLARIES
URINARY INCONTINENCE