- 作者：Wael Y. Khoder ; wael.khoder@med.uni-muenchen.de ; Boris Schlenker ; Raphaela Waidelich ; Alexander Buchner ; Nicole Kellhammer ; Christian G. Stief ; Armin J. Becker
- 刊名：Urology
- 出版年：2012
- 期刊代码：267_00904295
- 类别：med
- 出版时间：March, 2012
- 卷：79
- 期：3
- 页码：717-721
- 文件大小：242 K
Objective
To report our refinement of open intrafascial retropubic radical prostatectomy (OIF-RP) and 1-year follow-up results.Patients and Methods
OIF-RP was performed in 231 cases of clinically localized Prostate cancer in a prospective study from January 2007 to December 2009. Inclusion criteria were good potency (IIEF-5 score 鈮?5), Gleason score 鈮?, prostate-specific antigen (PSA) 鈮?0, and clinical T1-2 tumors. Endopelvic fascia was not incised, and the prostate capsule was freed laterally from surrounding fasciae and dorsally from Denonvillier's fascia, keeping all periprostatic fasciae/nerves intact. Functional outcomes were followed at 3 and 12 months (3 M and 12 M). Continence defined as complete (no pads), grade I (1-2pads/day) and grade II (>2pads/day).
Results
Median age was 63.3 years, body mass index 25.6, and PSA 5.4 ng/mL. Median operating time was 65 minutes (range 50-250), blood loss was 150 mL (range 50-1000), preoperative IIEF-score was 23 (range 15-25). Pathologic stage was pT2 (91%) and pT3 (9%). Gleason score was 鈮? (73%) and 鈮? (27%). Positive margins were 10%(pT2) and 65%(pT3). There were no postoperative complications/reinterventions. At 3 M, 60%of patients had full continence, and 86%had full continence at 12 M (鈮?0 years, 64%and 95%after 3 M and 12 M, respectively). At 3 M and 12 M, median IIEF-score was 14 (range 0-25) and 19 (range 0-25), respectively. Baseline IIEF-score was reached by 50%(3 M) and 78%(12 M) (P<.001). IIEF-score was inversely correlated to patients' age (鈮?0 years 92%, 60-69 years 77%, 鈮?0 years 60%).
Conclusion
OIF-RP follows rationales of radical prostatectomy and might be considered for selected patients. Preserving all periprostatic fasciae/nerves recuperates early continence and maintains potency without affecting oncological outcomes.