前列腺周围神经区间量化分析与前列腺癌手术方式改良的关系
Quantitative analysis of the periprostatic nerve distribution and the improvement of prostatectomy
目的 量化分析正常前列腺包膜周围神经纤维的典型分布模式。 方法 取15例正常前列腺及其周围筋膜标本，每例分别切取前列腺尖部、中部与基底部层面，行HE染色，显微镜下对各层面行“12区间法”统计各区神经纤维数目及比率。 结果 前列腺包膜外神经纤维大致呈对称性分布，64.4%~75.7%可计数神经纤维位于4/5与8/9区间，而24.3%~30.5%的神经则位于前列腺包膜前外侧与腹侧。 结论 1/4~1/3的神经纤维分支分布于前列腺包膜的前外侧及腹侧位置，本研究结果将为保留勃起功能的前列腺癌根治术的进一步改良提供理论依据。
Objectives To determine the typical pattern of nerve distribution along the prostatic capsule by counting in each sector. Methods Serial sections of 15 normal prostate specimens were investigated. A total of 90 slides taken from the apex, mid-part, and base of the prostate were analyzed under microscopy. Before microscopic observation, slides were divided into 12 sectors. Every single nerve and ganglion between the prostatic capsule and the periprostatic tissue was counted in each sector. Results The majority of nerves found in the sectors corresponded to the typical location of the NVB at the rectolateral sides of the prostate (4/5 or 8/9 o'clock sectors). In these two sectors, a median of 64.4~75.7% of counted nerves per slide was found. However, a signifcant amount of nerves (24.3%~30.5%) was detected above the horizontal line. Conclusions We conclude that 1/4-1/3 of nerves can be found along the ventral circumference of the prostatic capsule. To preserve a maximum number of nerves, we therefore recommend a modifcation of the surgical technique for nerve sparing on the ventral parts of the prostate.
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