Factors influencing unplanned re-operation of prostatic cancer and its countermeasures
10.3760/cma.j.issn.1000-6702.2019.12.006
- VernacularTitle: 微创根治性前列腺切除术后非计划再次手术的原因分析及应对策略
- Author:
Qijun WO
1
;
Xiaolong QI
;
Feng LIU
;
Qi ZHANG
;
Zujie MAO
;
Dahong ZHANG
Author Information
1. Department of Urology, Zhejiang Provincial People’s Hospital, Hangzhou People’s Hospital of Hangzhou Medical College, Hangzhou 310014, China
- Publication Type:Clinical Trail
- Keywords:
Prostatic neoplasms;
Prostatectomy;
Minimally invasive;
Unplanned re-operation;
Complications
- From:
Chinese Journal of Urology
2019;40(12):905-908
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the main causes for unplanned re-operation of prostatic cancer.
Methods:The clinical data of 4 patients with prostatic cancer who underwent an unplanned re-operation were analyzed retrospectively between September 2014 and July 2019 in our hospital.Preoperative data of patients was collected as follows: mean age of 65 years, ranged from 56 to 71 years.tPSA ranged from 5.17-13.20 ng/ml.Gleason score of 3+ 3 in 1 case, 3+ 4 in 2 cases, 4+ 4 in 1 case. pTNM pT2a in 2 Cases, pT2b in 2 cases. LRP(extraperitoneal approach) in 1 case, RARP(transperitoneal approach) in 3 cases.
Results:The main causes for unplanned re-operation were as follows: perioperative hemodynamic instability(75%, 3/4), post-operative fever(25%, 1/4). All 4 re-operations were performed by urologists using Laparoscopic exploration of abdomen.
Conclusions:Inadequate and inappropriate surgical hemostasis are the key to lead a second-look surgery of prostatic cancer.A complete hemostasis could help to lower the re-operation rate.Laparoscopic exploration of abdomen could be one of the choices to deal with re-operation after minimally invasive radical prostatectomy.
