Asistanlık eğitimi sırasında edinilmeyen Radikal Prostatektomi (RRP) eğitimi için her şey bitmiş midir?

Abstract

Amaç: Prostat kanseri (PK) erkeklerde çok sık olarak izlenen bir hastalıktır. Bu hastaların tedavisinde, radikal prostatektomi altın standart tedavi yöntemidir. Çoğu zaman asistanlık sürecinde bu eğitim tamamlanamaz. Bu çalışmanın amacı, uzmanlık sonrası dönemde eğitimlerle tamamlanan retropubik radikal prostatektomi (RRP) eğitiminin sonuçlarını sunmak ve bu süreçte edindiğimiz tecrübeyi bu işe yeni başlayacak kişilerle paylaşmaktır. 

Gereç ve Yöntemler: 2014‐2017 tarihleri arasında kliniğimizde ilk defa yapılan 50 RRP hastasının sonuçları gözden geçirildi. Hasta yaşı, ek hastalıklar, PSA değeri, patoloji sonuçları, dren süresi, hastanede kalma süresi ve komplikasyon gibi özellikleri retrospektif olarak kaydedildi. 

Bulgular: Ortalama PSA değeri 12.78± 9.76 (3.54-53) ng/dl olarak ölçüldü. Ortalama ameliyat süresi 178.7± 9.7 dakika olarak saptandı. Tahmini kan kaybı 833.3± 121.9 ml (600-1000) ve kan replasmanı 13 (%26) hastada yapıldı. Cerrahi loja yerleştirilen dren ortalama 2.38±1.24 (1-8) günde alındı. Hastanede ortalama kalış süresi ortalama 3.4± 0.9 (2-6) gün olarak saptandı. Hiçbir hastada organ ya da ciddi vasküler yaralanma izlenmedi. 

Sonuç: Prostat kanseri tedavisinde radikal prostatektomi, mükemmel sonuç, minimal komplikasyon oranları ve başarı ile uygulanmaktadır. Ancak zorluğu ve komplikasyonları nedeniyle çoğu üroloji doktorunun uzak durduğu bir konudur. Bizim çalışma sonuçlarında görüldüğü gibi, yeterince istekli ve gerekli eğitim programlarını tamamlayan kişilerce rahatlıkla uygulanabilir bir yöntem olduğu sonucuna ulaşılmıştır. 

Keywords

• İlk deneyim
• rostat kanser
• Radikal Retropubik Prostatektomi

Is it over if Radical Prostatectomy (RRP) training is not obtained during assistant education?

Abstract

Aim: Prostate cancer (PC) is a very common disease in men. Radical prostatectomy is the gold standard method for treatment of these patients. The majority of the time this education cannot be completed during the residency. The aim of this study is to present the results to retropubic radical prostatectomy (RRP) training completed in the period after specialization and to share our experience during this process with those newly starting. 

Material and Method: The results of 50 rrp patients first attending our clinic from 2014- 2017 were reviewed. Characteristics of the patients like ages, additional diseases, psa values, pathology results, drain duration, hospital stay and complications were retrospectively recorded.

Results: Mean PSA value was measured as 12.78± 9.76 (3.54-53) ng/dl. Mean surgical duration was 178.7± 9.7 minutes. Estimated blood loss was 833.3± 121.9 ml (600-1000) and blood replacement was performed for 13 (26%) patients. The mean duration of drain placed in the surgical site was 2.38±1.24 (1-8) days. Mean hospital stay was 3.4± 0.9 (2-6) days. No patient was observed to have organ or serious vascular injury. 

Conclusion: Radical prostatectomy for prostate cancer treatment is successfully performed with perfect results and minimal complication rates. However, due to difficulties and complications, it is a topic avoided by the majority of urologists. As observed in our study results, it was concluded that this is an easily applied method for individuals with sufficient motivation who have completed the necessary training programs. 

Keywords

• first experience
• prostate cancer
• radical retropubic prostatectomy

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