Sultan Raymond, Slova Denisa, Thiel Bob, Lepor Herbert
Department of Urology, New York University School of Medicine, New York, New York 10016, USA.
J Urol. 2006 Oct;176(4 Pt 1):1420-3. doi: 10.1016/j.juro.2006.06.011.
We identified factors that predict return to part-time and full-time work and resumption of unlimited physical activity following open radical retropubic prostatectomy.
Between July 1, 2002 and February 28, 2005, 537 men with clinically localized prostate cancer underwent open radical retropubic prostatectomy, as performed by a single surgeon. Intraoperative, perioperative and postoperative parameters were recorded in real time and entered into a database. An assessment was made 1 and 3 months postoperatively regarding time to return to work and unrestricted physical activity.
Of the men 50% returned to part-time and full-time work, and unrestricted activity within 14, 21 and 30 days after discharge home, respectively. Patient age and hematocrit at hospital discharge significantly predicted return to part-time and full-time work, and unlimited physical activity. The number of days that the urinary catheter was indwelling was also associated with return to part-time work. Occupation (blue vs white collar) and marital status were also associated with return to full-time work. In the multivariate model a unit increase in hematocrit decreased the time to return to part-time and full-time work, and unrestricted physical activity by 0.50, 0.60 and 0.59 days, respectively. Men with discharge hematocrit greater than 32% were 1.57 (p = 0.059), 1.65 (p = 0.041) and 2.03 (p = 0.002) times more likely to return to part-time and full-time work, and unlimited activity before 14, 21 and 30 days, respectively. Overall models were developed that accounted for 9.4%, 14.0% and 4.0% of the time to return to part-time work, full-time work and unrestricted physical activity, respectively.
Efforts to increase discharge hematocrit by minimizing intraoperative blood loss or using preoperative blood management strategies and earlier removal of the urinary catheter have a favorable impact on the return to work and physical activity.
我们确定了耻骨后根治性前列腺切除术后预测恢复兼职和全职工作以及恢复无限制体力活动的因素。
在2002年7月1日至2005年2月28日期间，537例临床局限性前列腺癌男性患者接受了由一名外科医生实施的耻骨后根治性前列腺切除术。术中、围手术期和术后参数实时记录并录入数据库。术后1个月和3个月对恢复工作和无限制体力活动的时间进行评估。
这些男性患者中，分别有50%在出院后14天、21天和30天内恢复兼职和全职工作以及无限制活动。患者年龄和出院时的血细胞比容显著预测了恢复兼职和全职工作以及无限制体力活动的情况。导尿管留置天数也与恢复兼职工作有关。职业（蓝领与白领）和婚姻状况也与恢复全职工作有关。在多变量模型中，血细胞比容每增加一个单位，恢复兼职和全职工作以及无限制体力活动的时间分别减少0.50天、0.60天和0.59天。出院时血细胞比容大于32%的男性在14天、21天和30天之前恢复兼职和全职工作以及无限制活动的可能性分别是1.57倍（p = 0.059）、1.65倍（p = 0.041）和2.03倍（p = 0.002）。总体模型分别解释了恢复兼职工作、全职工作和无限制体力活动时间的9.4%、14.0%和4.0%。
通过尽量减少术中失血或采用术前血液管理策略来提高出院时的血细胞比容以及尽早拔除导尿管，对恢复工作和体力活动有积极影响。
