He Minke, Li Yaohui, Xiang Zhuoyi, Sun Li-An, Zhu Yanjun, Hu Xiaoyi, Guo Jianming, Wang Hang
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China.
Medicine (Baltimore). 2018 Sep;97(36):e11686. doi: 10.1097/MD.0000000000011686.
The aim of our study was to investigate the effects of prostate biopsy on perioperative outcomes of robotic-assisted laparoscopic prostatectomy (RALP).A total of 181 patients who underwent the RALP in our institution have been retrospectively reviewed, patients were divided into different groups according to the interval of biopsy to RALP and core numbers of biopsy. Perioperative outcomes including estimated blood loss (EBL), operative time (OT), surgical margin status, postoperative drainage, hospital stay, and perioperative complications were served as endpoints.Interval of biopsy to RALP was not significantly correlated with any perioperative outcomes, while the biopsy core numbers had significant correlation with the EBL. In logistic regression analysis, the biopsy core numbers were associated with higher risk of positive surgical margins. Body mass index (BMI) was also a significant factor related to OT.Delay of the RALP after biopsy was not applicable in the era of RALP and surgeons could be more freely in selecting the time of RALP. Besides, further studies should focus on how to improve the diagnostic efficiency of prostate cancer without increasing the incidence of surgical complications.
我们研究的目的是调查前列腺活检对机器人辅助腹腔镜前列腺切除术(RALP)围手术期结局的影响。对在我们机构接受RALP的181例患者进行了回顾性分析,根据活检至RALP的时间间隔和活检的芯数将患者分为不同组。围手术期结局包括估计失血量(EBL)、手术时间(OT)、手术切缘状态、术后引流、住院时间和围手术期并发症作为观察终点。活检至RALP的时间间隔与任何围手术期结局均无显著相关性,而活检芯数与EBL有显著相关性。在逻辑回归分析中,活检芯数与手术切缘阳性风险较高相关。体重指数(BMI)也是与OT相关的一个重要因素。在RALP时代,活检后延迟RALP并不适用,外科医生在选择RALP时间方面可以更加自由。此外,进一步的研究应集中在如何在不增加手术并发症发生率 的情况下提高前列腺癌的诊断效率。