Rojo María Alejandra Egui, Martinez-Salamanca Juan Ignacio, Maestro Mario Alvarez, Galarza Ignacio Sola, Rodriguez Joaquin Carballido
Urology Department, Hospital Universitario de Fuenlabrada, Madrid, Spain.
Urology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
JSLS. 2014 Oct-Dec;18(4). doi: 10.4293/JSLS.2014.00024.
To analyze the effect of cosmetic outcome as an isolated variable in patients undergoing surgical treatment based on the incision used in the 3 variants of radical prostatectomy: open (infraumbilical incision and Pfannestiel incision) and laparoscopic, or robotic (6 ports) surgery.
612 male patients 40 to 70 years of age with a negative history of prostate disease were invited to participate. Each patient was evaluated by questionnaire accompanied by a set of 6 photographs showing the cosmetic appearance of the 3 approaches, with and without undergarments. Participants ranked the approaches according to preference, on the basis of cosmesis. We also recorded demographic variables: age, body mass index, marital status, education level, and physical activity.
Of the 577 patients who completed the questionnaries, the 6-port minimally invasive approach represents the option preferred by 52% of the participants, followed by the Pfannestiel incision (46%), and the infraumbilical incision (11%), respectively. The univariate and multivariate analyses did not show statistically significant differences when comparing the approach preferred by the patients and the sub-analyses for demographic variables, except for patients who exercised who preferred the Pfannestiel incision (58%) instead of minimally invasive approach (42%) with statistically significant differences.
The minimally invasive approach was the approach of choice for the majority of patients in the treatment of prostate cancer. The Pfannestiel incision represents an acceptable alternative. More research and investment may be necesary to improve cosmetic outcomes.
基于根治性前列腺切除术的3种术式（开放手术：脐下切口和Pfannestiel切口；腹腔镜手术或机器人辅助手术：6孔法）所采用的切口，分析美容效果作为一个独立变量在接受手术治疗患者中的影响。
邀请612例年龄在40至70岁、前列腺疾病史阴性的男性患者参与。每位患者通过问卷调查进行评估，并配有一组6张照片，展示3种术式穿着内衣和不穿内衣时的美容外观。参与者根据美容效果按偏好对术式进行排序。我们还记录了人口统计学变量：年龄、体重指数、婚姻状况、教育水平和身体活动情况。
在577例完成问卷调查的患者中，6孔微创术式是52%参与者的首选，其次是Pfannestiel切口（46%）和脐下切口（11%）。在比较患者首选的术式与人口统计学变量的亚分析时，单因素和多因素分析均未显示出统计学上的显著差异，但运动的患者更倾向于Pfannestiel切口（58%）而非微创术式（42%），差异具有统计学意义。
微创术式是大多数前列腺癌患者治疗的首选方法。Pfannestiel切口是一种可接受的替代方法。可能需要更多的研究和投入来改善美容效果。
