Eden Christopher G, Chang Christopher M, Gianduzzo Troy, Moon Daniel A
Department of Urology, The North Hampshire Hospital, Basingstoke, UK.
BJU Int. 2006 Dec;98(6):1279-82. doi: 10.1111/j.1464-410X.2006.06443.x. Epub 2006 Jul 28.
To investigate the effect of obesity on the operative variables of patients undergoing laparoscopic radical prostatectomy (LRP).
The database entries and case-notes of 532 consecutive patients undergoing LRP from March 2000 to August 2005 were examined retrospectively. Complete data were available on 505 (95%) patients, 108 (21%) of whom were obese (body mass index, BMI, > or = 30 kg/m2). All patients had clinical stage T < or = 3aN0M0 prostate cancer and had their procedure done or supervised by the same surgeon.
The patients' prostate-specific antigen level, Gleason score, clinical stage and prostate weight were similar. The mean values for patients deemed not obese and obese were: for operative duration (182 and 197 min, P = 0.01), blood loss (310 and 250 mL, P = 0.66), hospital stay (3.0 and 3.3 nights, P = 1.00), complications (3.5% and 4.6%, P = 0.77), positive margins (15.4% and 20.6%, P = 0.26) and biochemical recurrence (3.8% and 3.7%, P = 1.00) at a mean follow-up of 9.7 and 12.0 months, respectively.
The operation was significantly longer for obese patients, by a mean of 15 min; all other variables were comparable in the two groups. The results from this study suggest that obese patients can expect a similar outcome to their non-obese counterparts after LRP, when operated on by an experienced surgeon.
探讨肥胖对接受腹腔镜前列腺癌根治术(LRP)患者手术相关变量的影响。
回顾性分析2000年3月至2005年8月连续532例行LRP患者的数据库记录和病历。505例(95%)患者有完整数据,其中108例(21%)为肥胖患者(体重指数,BMI,≥30kg/m²)。所有患者临床分期为T≤3aN0M0前列腺癌,且手术由同一位外科医生完成或指导。
患者的前列腺特异性抗原水平、Gleason评分、临床分期和前列腺重量相似。非肥胖组和肥胖组患者的平均值如下:手术时间(182分钟和197分钟,P = 0.01)、失血量(310毫升和250毫升,P = 0.66)、住院时间(3.0晚和3.3晚,P = 1.00)、并发症发生率(3.5%和4.6%,P = 0.77)、切缘阳性率(15.4%和20.6%,P = 0.26)以及生化复发率(3.8%和3.7%,P = 1.00),平均随访时间分别为9.7个月和12.0个月。
肥胖患者手术时间明显延长,平均延长15分钟;两组其他所有变量相当。本研究结果表明,肥胖患者由经验丰富的外科医生进行LRP手术后,预期结果与非肥胖患者相似。