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前列腺活检后 2 周内行机器人辅助腹腔镜根治性前列腺切除术是否会影响疗效?

Does performance of robot-assisted laparoscopic radical prostatectomy within 2 weeks of prostate biopsy affect the outcome?

机构信息

Department of Urology, Yonsei University Health System, Gang-Nam Severence Hospital, Seoul, Korea.

出版信息

Int J Urol. 2011 Feb;18(2):141-6. doi: 10.1111/j.1442-2042.2010.02675.x. Epub 2010 Nov 16.

Abstract

OBJECTIVE

The aim of this study was to determine whether robot-assisted laparoscopic radical prostatectomy (RALP) performed within either 2 or 4 weeks of prostate biopsy is associated with surgical difficulty or immediate postoperative outcome.

METHODS

Of the 121 patients that underwent RALP at our institution, 104 patients were prospectively included. Patients were sequentially divided into three groups: first patient in group A (interval from biopsy to RALP: 2 weeks), second patient in group B (2-4 weeks), third patient in group C (more than 4 weeks), fourth patient in group A, and so on. The clinical, operative, pathological, and postoperative functional data were collected.

RESULTS

Group A consisted of 31 patients, group B of 33, and group C of 40 patients. Median patient age and median follow up were 61.1 years and 14.1 months, respectively. In group A, mean estimated blood loss was significantly higher than the other two groups, even though there was no significant difference in the mean console time. Postoperative complications did not make any difference among the groups. In the multivariable analysis, the interval from biopsy to surgery did not affect operative times or surgical margins, or the immediate postoperative outcomes (e.g. recovery of erectile function, continence, and biochemical recurrence).

CONCLUSION

A short interval for less than two weeks between the prostate biopsy and the RALP seems to be feasible and safe. Further studies with larger samples are needed to corroborate these findings.

摘要

目的

本研究旨在确定经直肠前列腺穿刺活检后 2 周或 4 周内行机器人辅助腹腔镜前列腺癌根治术(RALP)是否与手术难度或术后即刻结果相关。

方法

在我们机构行 RALP 的 121 例患者中,前瞻性纳入 104 例患者。患者被顺序分为三组:A 组(活检至 RALP 间隔时间:2 周)的第 1 位患者,B 组(2-4 周)的第 2 位患者,C 组(4 周以上)的第 3 位患者,A 组的第 4 位患者,以此类推。收集临床、手术、病理和术后功能数据。

结果

A 组 31 例,B 组 33 例,C 组 40 例。中位患者年龄和中位随访时间分别为 61.1 岁和 14.1 个月。A 组的平均估计失血量明显高于其他两组,尽管控制台时间的平均值没有显著差异。各组之间术后并发症无差异。多变量分析显示,从活检到手术的间隔时间不会影响手术时间或手术切缘,也不会影响术后即刻结果(如勃起功能、控尿和生化复发的恢复)。

结论

在经直肠前列腺穿刺活检后 2 周以内行 RALP 似乎是可行且安全的。需要进一步的大样本研究来证实这些发现。

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