Department of Urology, Sadıka Sabancı Hospital, 54050, Sakarya, Turkey.
Department of Urology, Sakarya University, School of Medicine, 54100, Sakarya, Turkey.
BMC Urol. 2023 Jun 7;23(1):105. doi: 10.1186/s12894-023-01277-8.
To determine the effectiveness of pelvis diameters in determining postoperative outcomes in men who underwent open radical cystectomy + urinary diversion, it is aimed to predict the factors that may affect the operative difficulty and possible surgical outcomes before the operation.
A total of 79 radical cystectomy patients operated in our institution with preoperative computed tomography (CT) were included the study. Pelvic dimensions; symphysis angle (SA), upper conjugate, lower conjugate, pelvic depth, apical depth (AD), interspinous distance (ISD), bone femoral width and soft tissue width were measured by preoperative CT. ISD index were defined as ISD/AD. Postoperative outcomes and indicators of operative difficulty were recorded. Regression analyses were used to predict perioperative and postoperative outcomes.
Total of 96 complications were observed in 52 of the 79 patients in ninety days (65,8%) with a mean age of 68.25 years. There were significant correlations between SA and body mass index (BMI) with operative time (p = 0.006, p < 0.001; respectively). For estimated blood loss, there were significant correlations between preoperative hematocrit (p = 0,031). Analysis of multivariate logistic regression revealed that higher Charlson comorbidity index (CCI) and BMI were found to be significant predictors for major complications while CCI, pathological T stage and ISD index are prominent predictors for surgical margin positivity.
Pelvic dimensions are not significant with minor or major complications. However, operative time may be associated with SA. Also, narrow and deep pelvis may increase the risk of positive surgical margins.
确定骨盆直径在男性接受开放式根治性膀胱切除术+尿路改道术后的术后结果中的有效性，旨在预测可能影响手术难度和手术结果的因素在手术前。
本研究共纳入 79 例在我院行根治性膀胱切除术的患者，所有患者均行术前计算机断层扫描（CT）检查。通过术前 CT 测量骨盆尺寸；耻骨角（SA）、上结合、下结合、骨盆深度、顶点深度（AD）、棘突间距离（ISD）、股骨干宽度和软组织宽度。定义 ISD 指数为 ISD/AD。记录术后结果和手术难度指标。使用回归分析预测围手术期和术后结果。
在 79 例患者中，有 52 例（65.8%）在 90 天内观察到 96 种并发症，平均年龄为 68.25 岁。SA 与体重指数（BMI）与手术时间之间存在显著相关性（p=0.006，p<0.001；分别）。对于估计失血量，术前血细胞比容与有显著相关性（p=0.031）。多变量逻辑回归分析显示，较高的Charlson 合并症指数（CCI）和 BMI 是发生主要并发症的显著预测因子，而 CCI、病理 T 期和 ISD 指数是手术切缘阳性的显著预测因子。
骨盆尺寸与小或大的并发症没有显著相关性。然而，手术时间可能与 SA 有关。此外，狭窄和深骨盆可能增加手术切缘阳性的风险。
