Operatie bij prostaatkanker: Hersteloperatie techniek bij prostaatkankerpatiënten na bestralingen zou grote verbeteringen aanbrengen in bijwerkingen zoals bij incontinentie en impotentie.

17th. of december 2004: source: Reuters Health Onderzoek in Memorial Sloan-Kettering Cancer Center heeft uitgewezen dat een hersteloperartie bij prostaatkankerpatiënten die door eerdere behandelingen, uitwendige of inwendige bestraling ernstige bijwerkingen hebben gekregen zoals incontinentie en impotentie deze significant verbeterden. 100 patiënten zijn in de periode 1984 tot 2003 gevolgd nadat deze allemaal met uitwendige of inwendige bestraling waren behandeld. Patiënten die daarna ernstige bijwerkingen kregen in de vorm van incontinentie en impotentie liep terug door hersteloperatie van 33$ naar 13% en patienten met inwendige rectale beschadiging liep terug van 15% naar 2%.. Hert advies van de onderzoekers is dan ook om deze hersteloperaties vaker uit te voeren. Er is wel een ervaren chirurg voor nodig wordt terzijde erbij opgemerkt. De studie is gepubliceerd in Journal of Urology. Hier een bericht van Reuters Health over deze studie

'Salvage' Prostate Surgery Has Improved

NEW YORK (Reuters Health) - For men with prostate cancer that recurs after radiation therapy, 'salvage' surgery to remove the prostate can lead to long-term cancer control, New York- based researchers report. Moreover, the side effects of the procedure are "acceptable," the team reports in the Journal of Urology.

"Salvage radical prostatectomy is technically demanding, but the procedure can be performed safely by an experienced surgeon," Dr. James A. Eastham told Reuters Health. "Although rates of urinary incontinence and erectile dysfunction are higher than after standard radical prostatectomy, these outcomes continue to improve."

Eastham, of Memorial Sloan-Kettering Cancer Center, and colleagues reviewed data from 100 patients who underwent the procedure between 1984 and 2003 following external beam radiation or radioactive seed implants.

Between 1993 and 2003, the rate of major complications dropped significantly from 33 percent to 13 percent, and the rate of rectal injury fell from 15 percent to 2 percent.

Five years after undergoing the operation, one third of patients were not incontinent, and the majority of the others required one pad daily or less.

Moreover, 23 patients who required three or more pads daily became continent after they were fitted with an artificial urinary sphincter.

As for erectile difficulties after five years, overall, the potency rate was 28 percent following nerve-sparing radical prostatectomy. However, among patients who were previously potent, 45 percent remained so.

Thus, the team concludes that the relatively good outcomes after salvage radical prostatectomy "should persuade more physicians to consider patients for this potentially curative procedure."

SOURCE: Journal of Urology, December 2004.

bestraling, radiotherapie, incontinentie, impotentie, prostaatkanker, hersteloperatie