Clinical comparative evaluation of radical retropubic and perineal prostatectomy approaches for prostate cancer

Abstract

11年間の恥骨後式の37例と会陰式の30例について検討した.恥骨後式の平均手術時間は3時間48分, 術中平均出血量は1, 060ml, 輸血は17例の平均輸血量は620mlに対して, 会陰式は各々3時間18分, 717ml, 輸血は1例のみ輸血量は700mlであり, いずれも恥骨後式より会陰式のほうが良好な成績を得られた.術中, 術後合併症の直腸損傷, 吻合部尿道狭窄及び尿禁制率については双方に差はみられなかった

We compared the outcomes, advantages, and disadvantages of retropubic and perineal approaches to radical prostatectomy for prostate cancer. From 1990 to 2000, 37 patients (average age: 66.6 years) who underwent radical retropubic prostatectomy (RRP) and 30 patients (average age: 70.1 years) who underwent radical perineal prostatectomy (RPP) were identified from the database of our department. Outcome measures included operative duration, estimated blood loss, blood transfusions, positive margins, complications, and incontinence rates. There were no differences between the RRP and RPP groups in complications, incontinence rates, or positive margins. The mean operative duration was 228 min in the RRP group and 198 mm in the RPP group (p < 0.05). The mean estimated blood loss was 1, 060 ml in the RRP group and 717 ml in the RPP group (p < 0.01). The mean volume of blood transfusions was 620 ml in 17 patients in the RPP group and 700 ml in one patient in the RPP group (p < 0.001). In conclusion, the clinical results of RRP and RPP groups were similar; the advantages of the perineal approach were shorter operative duration, smaller estimated blood loss and less blood transfusion.