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肥胖对腹腔镜根治性前列腺切除术的影响。

The impact of obesity on laparoscopic radical prostatectomy.

作者信息

Eden Christopher G, Chang Christopher M, Gianduzzo Troy, Moon Daniel A

机构信息

Department of Urology, The North Hampshire Hospital, Basingstoke, UK.

出版信息

BJU Int. 2006 Dec;98(6):1279-82. doi: 10.1111/j.1464-410X.2006.06443.x. Epub 2006 Jul 28.

Abstract

OBJECTIVE

To investigate the effect of obesity on the operative variables of patients undergoing laparoscopic radical prostatectomy (LRP).

PATIENTS AND METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

患者与方法

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。

结果

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。

结论

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。

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