南方医科大学学报

南方医科大学学报 ›› 2023, Vol. 43 ›› Issue (12): 2158-2162.doi: 10.12122/j.issn.1673-4254.2023.12.23

• • 上一篇    

罕见大体积（223 g）前列腺孤立性纤维性肿瘤腹腔镜下根治性切除术

廖佳靖，刘晓华，杜 伟，郭 凯，徐亚文   

  1. 南方医科大学珠江医院泌尿外科，广东 广州 510282；广州市海珠区沙园街社区卫生服务中心，广东 广州 510280
  • 出版日期:2023-12-20 发布日期:2023-12-29

Laparoscopic radical resection of large (223 g) solitary fibrous tumor of the prostate: a case report

LIAO Jiajing, LIU Xiaohua, DU Wei, GUO Kai, XU Yawen   

  1. Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China; Shayuan Street Community Health Service Center, Guangzhou 510280, China
  • Online:2023-12-20 Published:2023-12-29

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摘要： 目的 报告1例完全腹腔镜下根治性切除净质量223 g的罕见前列腺孤立性纤维性肿瘤，并分享腹腔镜下处理大体积前列腺肿瘤的相关诊疗经验。方法 患者男性，67岁，因“突发排尿困难半天”由社区卫生服务中心转诊我院，经直肠前列腺穿刺活检术确诊为前列腺孤立性纤维性肿瘤，排除手术禁忌症后，行腹腔镜下前列腺根治性切除术，手术过程包括前列腺根治性切除术和膀胱颈尿道吻合术。结果 手术耗时3 h15 min，术中出血量约100 mL，术后视检标本呈球形，大小约11 cm×7.5 cm×6 cm，称量净质量为223 g。术后病理为前列腺孤立性纤维性肿瘤（中危型）。术后5 d拔除盆腔引流管，术后1周拔除尿管，患者夜间控尿好、无失禁，白天活动时偶有漏尿，总体疗效满意，术后随访尿控效果满意，未见肿瘤复发、转移。结论 腹腔镜根治性前列腺切除质量大于200 g的前列腺肿瘤难度大，主刀需要具备丰富的腹腔镜手术经验，熟悉前列腺层面解剖，手术团队配合默契，掌握操作策略与方法，可轻松应对大体积前列腺肿瘤，同样也能达到满意的肿瘤学控制和功能学保护效果。

关键词: 腹腔镜；大体积前列腺肿瘤；前列腺孤立性纤维性肿瘤；根治性切除术

Abstract: A 67-year-old male patient was referred to our hospital by the community health service center for "sudden dysuria for half a day". The diagnosis of solitary fibrous tumor of the prostate was established after transrectal prostate biopsy. After excluding contraindications, laparoscopic radical prostatectomy with bladder neck urethrostomy was performed. The operation was completed in 3 h and 15 min with an intraoperative blood loss of about 100 mL. Postoperative examination of the resected tumor revealed a large spherical tumor mass measuring about 11 cm ×7.5 cm ×6 cm with a net weight of 223 g. Postoperative pathology suggested solitary fibrous tumor of the prostate (medium-risk type). The abdominal drainage tube was removed 5 days after the operation and the catheter was removed 1 week after operation. The patient had good urine control at night without incontinence but with occasional urine leakage during daytime, and the overall therapeutic effect was satisfactory. Postoperative follow-up found good urine control of the patient without signs of tumor recurrence or metastasis. Laparoscopic radical prostatectomy often is difficult for large prostate tumors with a weight exceeding 200 g, and requires the surgeon to have rich experience in laparoscopic surgery with good understanding of prostate anatomy and close cooperation of the operation team to achieve satisfactory oncology control and functional protection of the urinary system.

Key words: laparoscopy; large prostate tumor; prostate solitary fibrous tumor; radical resection