[Complications in 266 total prostatectomies].
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Biomedical subjects
Publications and source records attributed to D Zoedler.
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So far, 157 radical prostatectomies have been performed at our clinic. The patients have mainly been in stage A-B disease, but also several patients in stage C disease have been subjected to surgery. The five-year survival is 90%. Complications from the surgery are described and discussed.
A total retropubic prostatectomy is an exact, clearly defined operation, which, in our hands, has been extensively standardized: it lasts an average of 1 1/2 h, results in relatively little blood loss-in only 20% of the cases is one or more units of whole blood utilized-and is accompanied by complications that are kept within tolerable boundaries. Complete enuresis can be avoided by using a particular stitching technique for the outlet of the bladder. A considerable incontinence occurred in only one patient, who during the day was temporarily forced to wear a Cunningham clamp. In the postoperative stationary phase, mortality was 2%. A radical prostatectomy makes complete recovery from cancer of the prostate possible without mutilation and without aggravating functional injuries. It has, therefore, a secure place in the surgical therapy of cancer.
On the basis of statistics collected over ten years, indications for the surgical treatment of bladder tumors are arrived at. The scopes of the individual surgical approaches, such as transurethral resection and partial and total cystectomy, are discussed. If the preoperative diagnosis indicates a carcinoma that has infiltrated the musculature, it would be disastrous to let the most favorable time for cure slip by while treating with palliative measures a carcinoma that otherwise could have been definitively cured. On no account should a cystectomy represent the last, desperate attempt at therapy when all other measures have failed.
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