發(fā)布時(shí)間：2018-05-03 02:30

  本文選題：前列腺腫瘤 + 根治性前列腺切除�。� 參考：《中國(guó)現(xiàn)代醫(yī)學(xué)雜志》2017年08期

【摘要】：目的探討恥骨后根治性前列腺切除,結(jié)合個(gè)體化治療高危前列腺癌的療效。方法 94例高危前列腺癌中70例用3個(gè)月新輔助內(nèi)分泌治療,恥骨后根治性前列腺切除時(shí)行直腸膀胱隔(Denonvillier)筋膜前脂肪墊、前列腺、雙側(cè)神經(jīng)血管束整塊切除,對(duì)淋巴管造影提示可疑淋巴結(jié)轉(zhuǎn)移49例給予擴(kuò)大淋巴清掃,其余患者按恥骨后根治性前列腺切除(Walsh)方法行恥骨后前列腺癌切除。術(shù)后對(duì)≥p T3a、Gleason分級(jí)≥8、淋巴結(jié)轉(zhuǎn)移和切緣陽(yáng)性者給予6個(gè)月輔助內(nèi)分泌治療或局部外放療。比較高危與中低危前列腺癌的手術(shù)時(shí)間、術(shù)中出血量、相關(guān)并發(fā)癥和3及5年生存情況。結(jié)果恥骨后根治性前列腺切除治療高危與中低危前列腺癌在手術(shù)時(shí)間、術(shù)中出血量、相關(guān)并發(fā)癥、3年、5年總生生存率及腫瘤特異性生存率之間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論恥骨后根治性前列腺切除,結(jié)合術(shù)后輔助內(nèi)分泌治療或局部外放療的個(gè)體化處理,有望使部分局限性高危前列腺癌達(dá)到與中低危前列腺癌相似的治療效果。
[Abstract]:Objective to investigate the curative effect of posterior radical prostatectomy combined with individualized treatment for high risk prostate cancer. Methods 70 cases of high risk prostate cancer were treated with 3 months neoadjuvant endocrine therapy. Rectum bladder septum Denonvillier prefascial fat pad, prostate, bilateral nerve and vascular bundle were removed. Enlarged lymphotomy was performed in 49 patients with suspected lymph node metastasis, and the rest patients underwent retropubic prostatectomy according to retropubic radical prostatectomy (Walsh). Patients with Gleason grade 鈮，

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