Author/Editor		Bratuš, Dejan; Kolenc, Alojzij; Hlebič, Gregor
Title		Naše izkušnje z zdravljenjem omejenega karcinoma prostate z radikalno retropubično prostatektomijo
Translated title		Our results of treating early prostatic cancer by radical retropubic prostatectomy
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. Suppl 1
Publication year		2003
Volume		str. I-65-6
Language		slo
Abstract		Background. The prostatic cancer is the most common malignant tumor in aging men. At present time the only chance of complete elimination of the tumor and thus apossible cure is provided by radical prostatectomy during the early stage of the disease. We wanted to test on our material if this is true and how safe is the procedure. Methods. We performed 167 radical retropubic prostatectomies between 1992 and 2001. The 165 patients treated between the beginning of 1994 and the end of 2001 were included in our study. The average age at the time of surgery was 64.6 years. The average PSA value before surgery was 9.84 ng/ml The average Gleason score of the performed biopsies was 5.7 Results. After the surgery, PSA value dropped to 0.00 ng/ml in 93% of the patients and hasn't risen yet during the follow up. The hystologic examination showed the average Gleason score of 5.6 in the post surgical material. In 5.8% the lymph nodes showed metastases, even though the intraoperative frozen sections came back negative in all those cases. Among the perioperative complications were significant bleeding in 5 patients, reoperation due to the anastomotic dehiscence in 2 patients and rectal injury in 2 patients. The late complications are urinary incontinence in 21.5% of the patients and stricture in 21.8% of the patients. Conclusions. In our opinion and regarding our results the radical prostatectomy in early prostatic cancer is a safe procedure with good long-term results.
Summary		Izhodišča. Rak na prostati je najpogostejši malignom pri starejšem moškem. Bolnika je možno ozdraviti, če je diagnoza pravočasna, ko je proces še omejen na prostato. Trenutno je najuspešnejše zdravljenje radikalna prostatektomija. Metode. Na našem oddelku smo od leta 1992 pa do konca leta 2001 naredili 167 radikalnih retropubičnih prostatektomij. V današnji pregled smo vključili 165 bolnikov, ki smo jih zdravili med letom 1994 in koncem leta 2001. Povprečna starost bolnikov je bila 64,6 leta. Povprečna vrednost PSA pred posegom je bila 9,84 ng/ml, vrednost seštevka po Gleasonu pa 5,7. Rezultati. Po operaciji je pri 93% bolnikov vrednost PSA padla na 0, 00 ng/ml in se v času spremljanja še ni dvignila. Povprečna vrednost seštevka po Gleasonu je bila v materialu, dobljenem z operacijo, 5,6. Bezgavke so bile preraščene z metastazami v 5,8%, čeprav so tudi v teh primerih izvidi zmrzlega reza bili negativni. Od zapletov ob posegu smo opažali večjo krvavitev pri petih bolnikih, zaradi dehiscence anastomoze je bila potrebna ponovna operacija pri dveh bolnikih, imeli smo tudi iatrogeno poškodbo rektuma pri dveh bolnikih. Od poznih zapletov opažamo stenozo na mestu anastomoze pri 21,8% bolnika in inkontinenco pri 21,5% bolnikov. Zaključki. Radikalna retropubična prostatektomija je operacija s sorazmerno majhnim številom zapletov in dobrimi rezultati. Bolnika je zato potrebno odkriti v zgodnji fazi bolezni in ga aktivno zdraviti.
Descriptors		PROSTATIC NEOPLASMS PROSTATECTOMY TREATMENT OUTCOME