超音波凝固切開装置(AutoSonix System)を用いた恥骨後式根治的前立腺摘除術の検討

Abstract

1年間に前立腺癌の恥骨後式根治的前立腺摘除術を施行された24例を対象に, 超音波凝固切開装置であるAutoSonix Systemを用い, 検討した.リンパ節郭清を含めた総出血量80から4llmlと手術成績は良好であった.同種血輸血は元々ヘモグロビン10.0g/dl以下の貧血を認めた2例にのみ施行した.術中, 術後とも重篤な合併症を認めず, 術後2週間の時点での尿道膀胱造影で全例吻合部での漏れは認めなかった.術後3ヵ月以上経過した症例ではパッドが必要な尿失禁は1例も認められず, 又, 1例で吻合部狭窄が認められたため尿道ブジーを施行し, 経過観察中である

We report our experience of using the ultrasonic coagulating and cutting device, AutoSonix System, which began in January 2000 to reduce the amount of bleeding in radical retropubic prostatectomy. The mean age of the 24 prostate cancer patients operated on was 68.2 years old. The operation results were excellent; the mean operation time was 227 +/- 29 minutes (mean +/- standard deviation), and the mean amount of blood loss during the operation was 215 +/- 114 ml. There were no major complications. After three months or more of follow-up, no patients needed any pads for urinary incontinence. Only one case showed a stricture at cystourethral anastomosis. AutoSonix System was useful to reduce the blood loss from the venous plexus in the pelvic cavity. We believe that radical prostatectomy would be safer if this device would be used by the urologist.