臨床泌尿器科60巻6号

2006年05月発行

綜説

会陰式根治的前立腺全摘除術

著者： 白木良一¹

所属機関： ¹藤田保健衛生大学泌尿器科

ページ範囲：P.351 - P.359

文献概要

要旨　限局性前立腺癌に対する手術法として最も歴史のある会陰式根治的前立腺全摘除術につき総説する。本術式の特徴は恥骨後式に比べ，手術時間が短く出血量が少ない。尿道膀胱吻合（尿路再建）が直視下で確実であり，カテーテル留置期間が短い。術後尿禁制の回復が早く，社会復帰が早い。医療経済的にも，準備品などの投資や術後のQOL回復も他に比べ優位である。反面，骨盤リンパ節郭清は不可である。適応は主にT1c例で，ブラキセラピーなどの低侵襲治療に向かないLUTSを有する腺腫を伴った症例や，若年例，下腹部手術の既往例などには今後も本術式が施行されると考えられる。局所前立腺癌に対する手術療法の選択には本術式もその選択範囲に入れておくべきものと考えられる。

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