Hong Sung Kyu, Lee Seung Tae, Kim Sung Soo, Min Kyung Eun, Hwang In Sik, Kim Myung, Jeong Seong Jin, Byun Seok-Soo, Hwang Sung Il, Lee Sang Eun
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
BJU Int. 2009 Sep;104(5):664-8. doi: 10.1111/j.1464-410X.2009.08624.x. Epub 2009 May 18.
To evaluate the effect of bony pelvic dimensions measured by preoperative magnetic resonance imaging (MRI) on performing robot-assisted laparoscopic prostatectomy (RALP).
In this exploratory study, we analysed the data of 141 patients who underwent RALP for clinically localized prostate cancer after undergoing MRI at our institution. Associations of various clinicopathological factors were analysed, including pelvic dimensions measured by preoperative MRI, with operative duration, estimated blood loss (EBL), surgical margin status, and postoperative urinary continence and erectile function.
For operative duration, no pelvic dimension had a significant association on univariate analysis, with only the newly developed variable of pelvic cavity index approaching significance (P=0.071). Only prostate volume had a significant association with operative duration on multivariate analysis (P=0.015). For EBL, no bony pelvic dimension had a significant association on univariate analysis, with only intertuberous distance and interspinous distance approaching significance (P=0.087 and P=0.072, respectively). Again, only prostate volume was significantly associated with EBL on univariate analysis (P=0.045). No pelvic dimension had any significant effect on surgical margin status, recovery of urinary continence or erectile function at 6 months after RALP.
Bony pelvic dimensions may not be a significant factor contributing to the technical difficulty of RALP among Korean patients compared with other patient-related factors such as prostate volume.
评估术前磁共振成像(MRI)测量的骨盆骨尺寸对机器人辅助腹腔镜前列腺切除术(RALP)的影响。
在这项探索性研究中,我们分析了在本院接受MRI检查后因临床局限性前列腺癌接受RALP手术的141例患者的数据。分析了各种临床病理因素之间的关联,包括术前MRI测量的骨盆尺寸与手术时间、估计失血量(EBL)、手术切缘状态以及术后尿失禁和勃起功能之间的关联。
对于手术时间,单因素分析中没有骨盆尺寸有显著关联,只有新开发的盆腔指数变量接近显著水平(P = 0.071)。多因素分析中只有前列腺体积与手术时间有显著关联(P = 0.015)。对于EBL,单因素分析中没有骨盆骨尺寸有显著关联,只有坐骨结节间距离和棘突间距离接近显著水平(分别为P = 0.087和P = 0.072)。同样,单因素分析中只有前列腺体积与EBL有显著关联(P = 0.045)。没有骨盆尺寸对RALP术后6个月的手术切缘状态、尿失禁恢复或勃起功能有任何显著影响。
与前列腺体积等其他患者相关因素相比,骨盆骨尺寸可能不是导致韩国患者RALP技术难度增加的重要因素。