摘要
目的:阐明前列腺周围结构的解剖组织学特征以指导前列腺癌根治术。方法:取南方医科大学临床解剖学研究所2004-01/2006-01的26例正常前列腺及其周围组织标本和珠江医院和解放军第四五二医院2004-01/2006-01的45例耻骨后前列腺癌根治术切除标本,采用苏木素-伊红染色方法对标本进行染色,显微镜下观察Denonvillier筋膜、盆侧筋膜、前列腺包膜、前纤维肌肉基质和神经血管束及相互关系。结果:①Denonvillier筋膜与前列腺包膜在前列腺后面正中融合者正常组和前列腺癌根治组分别有25例(96%,25/26),44例(98%,44/45)。在前列腺后面两侧,所有标本Denonvillier筋膜与前列腺包膜分离。②14例(54%,14/26)正常组和前列腺癌根治组25例(56%,25/45)标本盆侧筋膜在侧面和前列腺包膜由脂肪组织隔开,12例(46%,12/26)正常组和前列腺癌根治组20例(44%,20/45)结合。③50%正常组和前列腺癌根治组的神经血管束定位于后外侧,并形成确定的束。④所有标本都可看到从前列腺包膜至前纤维肌肉基质有平滑肌移行。在正常组23例(89%,23/26)和前列腺癌根治组41例(91%,41/45)标本中,在前列腺前面看不到前列腺包膜,在正常组3例(11%,3/26)和前列腺癌根治组4例(9%,4/45)标本中可以分辨出前列腺包膜和前纤维肌肉基质。在正常组24例(92%,24/26)和前列腺癌根治组36例(80%,36/45)标本的前面和侧面的最外面区域覆盖着盆侧筋膜。结论:Denonvillier筋膜、前列腺包膜、神经血管束、盆侧筋膜和前纤维肌肉基质关系密切,结构相互间关系在不同个体间存在变异。
AIM： To illuminate anatomical histological characteristics of periprostatic tissues, so as to instruct the radical prostatectomy. METHODS： Twenty-six normal specimens of sparing prostata and periprostatic tissues between January 2004 and January 2006 were selected from the Department of Clinical Anatomy of Southern Medical University and 45 radical retropubic prostatectomy specimens between between January 2004 and January 2006 were selected from the 452 Hospital of Chinese PLA and Zhujiang Hospital. Hematoxylin-eosin staining was adopted to study Denonvillier＇s fascia, lateral pelvic fascia, prostatic capsule, anterior fibromuscular stroma, neurovascular bundle as well as the relationship among them under microscope. RESULTS： ①Denonvilliers＇ fascia and the prostatic capsule adhered tightly at the center of the posterior aspect were found in 25 cases （96%, 25/26） of the normal prostate group, and in 44 cases （98%, 44/45） of the radical prostatectomy group respectively. Denonvilliers＇ fascia and the prostatic capsule were separated at the lateral aspect of the posterior in all cases.②The lateral pelvic fascia and the prostatic capsule were separated by adipose tissue in 14 cases （54%, 14/26） of the normal prostate group, and in 25 cases （56%, 25/45） of the radical prostatectomy group, and were adhered in 12 cases （46%, 12/26） and 20 cases （44%, 20/45） respectively in above two groups.③The neurovascular bundle of 50% patients in the normal group and radial prostatectomy group localized at the postero-lateral region with definite ‘bundle＇ formations. ④ A smooth transition from the prostatic capsule to the anterior fibromuscular stroma could be observed in all cases. No prostatic capsule could be seen at the anterior aspect in 23 cases （89%, 23/26） of the normal group as well as in 41 cases （91%, 41/45） of the radical prostatectomy group. In 3 cases （11%, 3/26） of the normal group and 4 patients （9%, 4/45） of the radical prostatectomy group, the capsule could be discriminated from the anterior fibromuscular stroma. The lateral pelvic fascia connected and fused with the anterior fibromuscular stroma, and covered the outermost regions of the lateral and anterior surfaces in 24 cases （92%, 24/26） of the normal group and 36 cases （80%, 36/45） of the radical prostatectomy group respectively. CONCLUSION： There are close relationships among Denonvillier＇s fascia, lateral pelvic fascia, prostatic capsule, anterior fibromuscular stroma and neurovascular bundle, which are different among, different oarts.
出处
《中国临床康复》
CSCD
北大核心
2006年第36期104-106,共3页
Chinese Journal of Clinical Rehabilitation
基金
国家科技攻关计划项目(2004BA709B3)~~
