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【文摘发布】目前根治性前列腺切除术技术

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http://www.co-urology.com/pt/re/courology/abstract.00042307-200703000-00005.htm;jsessionid=GgqYvgGHlgTn1t2X1CNKR2y95cyDY53Rq6vRnYTKnsQyhTGpZv2n!-712222271!-949856144!8091!-1

Laparoscopic radical prostatectomy: current techniques.

Minimally invasive surgery in urology

Current Opinion in Urology. 17(2):98-103, March 2007.
Levinson, Adam W; Su, Li-Ming
Abstract:
Purpose of review: Laparoscopic radical prostatectomy is now considered the standard of care at many centers for the treatment of localized prostate cancer. As with other surgical approaches, there has been an evolution in surgical techniques. Critical evaluation of the effects of these changes on clinical and pathologic outcomes continues. Recent findings: The technique of nerve sparing laparoscopic radical prostatectomy should attempt to mimic the techniques and outcomes of open surgery, while maintaining the advantages of reduced blood loss and morbidity, and greater visualization. Long-term functional and oncologic outcomes appear equivalent to open surgery. Surgical approaches based upon recent anatomic studies of the periprostatic neuroanatomy continue to spur both advances and debate. Athermal dissection near the neurovascular bundle, along with high release of the surrounding fascia, may hasten recovery of erectile function. Techniques of sparing or reconstructing the puboprostatic ligaments and support of the bladder are evolving in efforts to improve continence results. Debate over the merits of transperitoneal vs. extraperitoneal approaches to laparoscopic prostatectomy continues. Summary: Nerve sparing laparoscopic radical prostatectomy, although technically challenging, has proven to be an excellent alternative for dedicated centers wishing to provide a minimally invasive surgical option to their patients with localized prostate cancer.

(C) 2007 Lippincott Williams & Wilkins, Inc.

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2007-06-02 17:26 浏览 : 776 回复 : 1

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初译：

http://www.co-urology.com/pt/re/courology/abstract.00042307-200703000-00005.htm;jsessionid=GgqYvgGHlgTn1t2X1CNKR2y95cyDY53Rq6vRnYTKnsQyhTGpZv2n!-712222271!-949856144!8091!-1

Laparoscopic radical prostatectomy: current techniques. 目前根治性前列腺切除术技术

Minimally invasive surgery in urology

Current Opinion in Urology. 17(2):98-103, March 2007.
Levinson, Adam W; Su, Li-Ming
Abstract: 摘要：

Purpose of review: Laparoscopic radical prostatectomy is now considered the standard of care at many centers for the treatment of localized prostate cancer. As with other surgical approaches, there has been an evolution in surgical techniques. Critical evaluation of the effects of these changes on clinical and pathologic outcomes continues.
评论目的：腹腔镜根治性前列腺切除术目前被认为是在许多中心治疗局限性前列腺癌的标准。如同其他外科手术一样，其在手术技术方面亦存在着改经。这些变化对临床和病理的结局都会产生重要的影响并一直持续。

Recent findings: The technique of nerve sparing laparoscopic radical prostatectomy should attempt to mimic the techniques and outcomes of open surgery, while maintaining the advantages of reduced blood loss and morbidity, and greater visualization. Long-term functional and oncologic outcomes appear equivalent to open surgery. Surgical approaches based upon recent anatomic studies of the periprostatic neuroanatomy continue to spur both advances and debate. Athermal dissection near the neurovascular bundle, along with high release of the surrounding fascia, may hasten recovery of erectile function. Techniques of sparing or reconstructing the puboprostatic ligaments and support of the bladder are evolving in efforts to improve continence results. Debate over the merits of transperitoneal vs. extraperitoneal approaches to laparoscopic prostatectomy continues.
最近发现：保留神经的腹腔镜根治性前列腺切除术应类似开放手术技术效果，其可具有减少失血量以及降低死亡率并视野更清晰的优点。术后长期功能和分子结局似乎相当于开放手术。手术径路给予最近前列腺周神经解剖学的解剖研究，研究会在将来有所进展并引起相关讨论。神经血管束附近进行钝性解剖分离并周围筋膜的高位保护可能促进勃起功能的恢复。保留神经技术或重建耻骨前列腺韧带以及支持膀胱可带来膀胱排尿可控性。关于腹腔镜前列腺切除术中经腹膜抑或腹膜外径路的优点仍存在争议。

Summary: Nerve sparing laparoscopic radical prostatectomy, although technically challenging, has proven to be an excellent alternative for dedicated centers wishing to provide a minimally invasive surgical option to their patients with localized prostate cancer.
总结：尽管存在挑战，对于局限性前列腺癌患者，保留神经的腹腔镜根治性前列腺切除术对于专科中心想要施行微创手术仍被证实为一种良好选择。

(C) 2007 Lippincott Williams & Wilkins, Inc.

编译投稿：

【据《泌尿外科当前观点》2007年3月较新一期文摘发布】题为：目前根治性前列腺切除术技术

在该文章中作者评述到，腹腔镜根治性前列腺切除术目前被认为是在许多中心治疗局限性前列腺癌的标准。如同其他外科手术一样，其在手术技术方面亦存在着改经。这些变化对临床和病理的结局都会产生重要的影响并一直持续。而最近发现，保留神经的腹腔镜根治性前列腺切除术应类似开放手术技术效果，其可具有减少失血量以及降低死亡率并视野更清晰的优点。术后长期功能和分子结局似乎相当于开放手术。手术径路给予最近前列腺周神经解剖学的解剖研究，研究会在将来有所进展并引起相关讨论。神经血管束附近进行钝性解剖分离并周围筋膜的高位保护可能促进勃起功能的恢复。保留神经技术或重建耻骨前列腺韧带以及支持膀胱可带来膀胱排尿可控性。关于腹腔镜前列腺切除术中经腹膜抑或腹膜外径路的优点仍存在争议。尽管存在挑战，对于局限性前列腺癌患者，保留神经的腹腔镜根治性前列腺切除术对于专科中心想要施行微创手术仍被证实为一种良好选择。

2007-06-02 17:27

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