Yang Hua, Wu Bo, Liu Xuchang, Jia Kaiyuan, Bing Junyuan, Gao Yangjie, Shen Pengliang, Cao Xiaoming
Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, 030001, China.
World J Surg Oncol. 2025 Apr 30;23(1):176. doi: 10.1186/s12957-025-03812-3.
This study aims to analyze the risk factors for positive surgical margins following robot-assisted laparoscopic radical prostatectomy with Retzius-sparing (RS-RARP) to provide a basis for clinical preoperative evaluation and intraoperative decision-making.
A retrospective analysis was conducted on the clinical data of 103 patients who underwent RS-RARP at the First Hospital of Shanxi Medical University from May 2022 to May 2024. Patients were divided into positive margin and negative margin groups, as well as apical positive margin and apical negative margin groups based on surgical margin status. Patient demographics, preoperative data, and postoperative data were collected. Univariate and multivariate logistic regression analyses were used to evaluate the relationship between various factors and surgical margin status.
A total of 103 patients were included, with 31 cases (30.1%) in the positive margin group and 72 cases (69.9%) in the negative margin group. The results of the Logistic Regression With Variable Reduction indicated that prostate volume (OR = 10.90, 95% CI: 3.49-34.04, p < 0.001) and ≥pT3 stage tumors (OR = 8.78, 95% CI: 2.54-30.42, p < 0.001) were independent risk factors for positive surgical margins. Additionally, they were also significantly associated with an increased risk of positive surgical margins at the prostate apex.
The study indicates that prostate volume and pT stage are notable predictors of positive surgical margins in RS-RARP.
本研究旨在分析保留耻骨后间隙的机器人辅助腹腔镜根治性前列腺切除术（RS-RARP）后手术切缘阳性的危险因素，为临床术前评估和术中决策提供依据。
对2022年5月至2024年5月在山西医科大学第一医院接受RS-RARP的103例患者的临床资料进行回顾性分析。根据手术切缘状态将患者分为切缘阳性组和切缘阴性组，以及尖部切缘阳性组和尖部切缘阴性组。收集患者的人口统计学资料、术前数据和术后数据。采用单因素和多因素logistic回归分析评估各种因素与手术切缘状态之间的关系。
共纳入103例患者，切缘阳性组31例（30.1%），切缘阴性组72例（69.9%）。变量简化logistic回归结果表明，前列腺体积（OR = 10.90，95%CI：3.49 - 34.04，p < 0.001）和≥pT3期肿瘤（OR = 8.78，95%CI：2.54 - 30.42，p < 0.001）是手术切缘阳性的独立危险因素。此外，它们还与前列腺尖部手术切缘阳性风险增加显著相关。
该研究表明，前列腺体积和pT分期是RS-RARP中手术切缘阳性的显著预测因素。
