氩氦刀冷冻联合经尿道前列腺电切术治疗中叶明显突入膀胱的前列腺癌

目的 探讨氩氦刀冷冻联合经尿道前列腺电切术(TURP)治疗中叶明显突入膀胱的前列腺癌的安全性和近期疗效.方法 采用经直肠超声引导下经会阴前列腺癌氩氦刀冷冻联合经尿道前列腺中叶切除术治疗中叶明显突入膀胱的初诊前列腺癌患者2例.术后2个月复查血前列腺特异抗原(PSA),以及盆腔CT或MRI.结果 2例患者手术均顺利完成,手术时间、冷冻复温时间、术中出血量分别为115 min、50 min、20 ml,110 min、52 min、15 ml.术后无明显血尿及导尿管堵塞等,2周后顺利拔除导尿管,未出现尿潴留及尿失禁.患者术前、术后2个月盆腔CT或MRI对比显示:前列腺明显缩小,突入膀胱的中叶已消失.2例患者术后2个月复查PSA分别为0.909、0.26 ng/ml.结论 氩氦刀冷冻联合TURP治疗中叶明显突入膀胱的前列腺癌安全可行,近期疗效确切.

Cryosurgery ablation combined with transurethral resection of the prostate for treatment of prostate cancer with middle leaf protruding into the bladder

ObjectiveTo investigate the safety and early efficacy of the cryosurgery ablation combined with transurethral resection of the prostate (TURP) for treatment of prostate cancer with middle leaf protruding into the bladder. MethodsTwo prostate cancer patients with middle leaf protruding into the bladder were treated by rectal ultrasound-guided argon-hilium percutaneous cryoablation combined with TURP. The prostate specific antigen (PSA) was examined and CT or MRI was performed two months after cryoablation. ResultsThe operation was successfully performed in both cases, with the operation time, rewarming time, and bleeding volumes being 115 min/110 min, 50 min/52 min, and 20 ml/15 ml, respectively. There was no hematuresis or Foley catheter blockage in the two cases, and the urinary catheters were successfully removed two weeks after operation, with no urine retention or urinary incontinence. Preoperative and postoperative (2 months later) pelvic CT or MRI scans showed that the prostatic volume was greatly reduced and the middle leaf protruding into the bladder disappeared. PSA levels were 0.909 ng/ml and 0.26 ng/ml two months after operation. ConclusionCryosurgery ablation of the prostate combined with TURP is safe and effective for treatment of prostate cancer with the middle leaf protruding into the bladder.