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前列腺活检至机器人辅助腹腔镜根治性前列腺切除术(RALP)的时间间隔:对手术难度的影响。

Interval from Prostate Biopsy to Robot-Assisted Laparoscopic Radical Prostatectomy (RALP): Effects on Surgical Difficulties.

作者信息

Kim In Sung, Na Woong, Nam Jung Su, Oh Jong Jin, Jeong Chang Wook, Hong Sung Kyu, Byun Seok Soo, Lee Sang Eun

机构信息

Department of Urology, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Korean J Urol. 2011 Oct;52(10):664-8. doi: 10.4111/kju.2011.52.10.664. Epub 2011 Oct 19.

Abstract

PURPOSE

Traditionally, an interval of 4 to 6 weeks has been recommended after prostate biopsy before open radical prostatectomy. However, such an interval is not explicitly specified in robot-assisted laparoscopic radical prostatectomy (RALP). This study was designed to determine whether the interval from prostate biopsy to RALP affects surgical difficulties.

MATERIALS AND METHODS

Between January 2008 and May 2009, a total of 237 men underwent RALP in our institution. The interval from biopsy to RALP was categorized as follows: ≤ 2 weeks, >2 to ≤ 4 weeks, >4 to ≤ 6 weeks, >6 to ≤ 8 weeks, and >8 weeks. Multivariate analysis was used to identify whether the interval from prostate biopsy to RALP was an independent predictor of operative time, estimated blood loss (EBL), margin positivity, continence, and potency.

RESULTS

Among the 5 groups, there were no significant differences in age, body mass index (BMI), preoperative serum prostate-specific antigen (PSA), prostate volume, or preoperative International Index of Erectile Dysfunction-5 score (all p>0.05). In the multivariate analysis, operative time was significantly associated with prostate volume. EBL was associated with prostate volume and BMI. Margin positivity was associated with preoperative serum PSA, prostate volume, and biopsy Gleason score. Postoperative continence and potency were significantly associated with age. However, in univariate and multivariate analyses, the interval from biopsy to RALP was not significantly associated with operative time, EBL, margin positivity, postoperative continence, or potency (all p>0.05).

CONCLUSIONS

Our data suggest that the interval from prostate biopsy to RALP is not related to surgical difficulties.

摘要

目的

传统上,建议在前列腺活检后4至6周的间隔期后进行开放性根治性前列腺切除术。然而,在机器人辅助腹腔镜根治性前列腺切除术(RALP)中并未明确规定这样的间隔期。本研究旨在确定从前列腺活检到RALP的间隔时间是否会影响手术难度。

材料与方法

2008年1月至2009年5月期间,共有237名男性在我们机构接受了RALP。从活检到RALP的间隔时间分类如下:≤2周、>2至≤4周、>4至≤6周、>6至≤8周以及>8周。采用多变量分析来确定从前列腺活检到RALP的间隔时间是否是手术时间、估计失血量(EBL)、切缘阳性、控尿和性功能的独立预测因素。

结果

在这5组中,年龄、体重指数(BMI)、术前血清前列腺特异性抗原(PSA)、前列腺体积或术前国际勃起功能障碍指数-5评分均无显著差异(所有p>0.05)。在多变量分析中,手术时间与前列腺体积显著相关。EBL与前列腺体积和BMI相关。切缘阳性与术前血清PSA、前列腺体积和活检Gleason评分相关。术后控尿和性功能与年龄显著相关。然而,在单变量和多变量分析中,从活检到RALP的间隔时间与手术时间、EBL、切缘阳性、术后控尿或性功能均无显著相关性(所有p>0.05)。

结论

我们的数据表明,从前列腺活检到RALP的间隔时间与手术难度无关。

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