복강경 보조 근치적 전립선적출술의 초기 경험
Early Experience of Laparoscope Assisted Radical Retropubic Prostatectomy
박성열, 이성진, 이재원, 이춘용,
소속 상세정보
박성열 ( Park Sung-Yul )
한양대학교 의과대학 비뇨기과학교실
이성진 ( Lee Seoung-Jin )
한양대학교 의과대학 비뇨기과학교실
이재원 ( Lee Je-Won )
한양대학교 의과대학 비뇨기과학교실
이춘용 ( Lee Tchun-Yong )
한양대학교 의과대학 비뇨기과학교실
KMID : 0358320070480010018
Abstract
Purpose: A laparoscopic radical prostatectomy(LRP) is a less invasive alternative to a conventional radical prostatectomy. However, the learning curve for a LRP is steep; therefore, becoming skilled at the procedure is difficult. Herein, our experience of laparoscope assisted radical retropubic prostatectomy(LARRP) is reported.
Materials & Methods: LARRP was performed on 16 patients with clinically organ confined prostate cancer. The mean age and serum prostate- specific antigen(PSA) of the patients were 63±5.7 years(51-70) and 20.01?24.8ng/ml(3.45-97.50), respectively. A longitudinal skin incision was made from the symphysis pubis to midway of the umbilicus. The incision was retracted with a self-retractor, without port placement and gas insufflation. The laparoscope was directly inserted into the wound, with modified bilateral pelvic lymph node dissection, prostatectomy and vesicourethral anastomosis performed under laparoscopic monitoring, using both open and laparoscopic instruments in the same order as for open surgery.
Results: The mean operative time was 282±45.7 minutes(200-375), including the time required for the modified bilateral pelvic lymphadenectomy. The mean estimated blood loss and specimen weight were 2,500±1,247ml(500-5,000) and 53±19.0gm(20-98), respectively. The surgical margins and lymph nodes were positive in 3(19%) and 2 patients (13%), respectively. The mean number of dissected lymph node and incision length were 12±7.5(4-31) and 11±3.2cm(6-15), respectively. Gradual recovery of continence occurred in 13(93%) for 1 years after the operation. Conclusions:
Conclusion: urve associated with a LRP. LARRP may be a bridge between an open RRP and a pure LRP. With the increase in the number of cases, LARRP may prove to be an effective treatment option for localized prostate cancer. (Korean J Urol 2007;48:18-23)
키워드
Cancer;Prostate;Prostatectomy;Laparoscopy
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