Aybal Halil Cagri, Yilmaz Mehmet, Barlas Irfan Safak, Duvarci Mehmet, Dagli Isa, Akdagcik Zeynep, Guven Selcuk, Tunc Lutfi
Clinic of Urology, Polatlı Duatepe State Hospital, Ankara, Turkey.
Urology, MediClin Kraichgau-Klinik, Bad Rappenau, Germany.
Ann Surg Oncol. 2025 Aug 25. doi: 10.1245/s10434-025-18175-y.
This study aimed to evaluate the relationship of perioperative estimated blood loss (EBL) with peri- and postoperative parameters during the robot-assisted radical prostatectomy (RARP) procedure.
In this retrospective study, data from patients with localized prostate cancer (PCa) who underwent RARP between December 2012 and August 2024 (n = 530) were analyzed. Patients with EBL of 100 ml or less were defined as group 1 (n = 359), and those with EBL exceeding 100 ml were defined as group 2 (n = 166). Perioperative data and postoperative functional and pathologic outcomes were recorded and compared between the two groups.
The patients in group 2 had longer lymph node dissection time, prostatectomy time, anastomosis time, total operation time, drain removal time, and hospital stay, as well a greater EBL, higher surgical margin ratio, greater positive surgical margin according to pathologic stage, and longer time to reach continence (p = 0.001). No difference was observed between urinary incontinence (UI) scores at the sixth month postoperatively (p = 0.191). A high degree of correlation was observed between EBL and other parameters (drain removal time, hospital length of stay, time to reach continence, prostatectomy time, International Consultation on Incontinence Questionnaire [ICIQ] total score at the first and third months, and total operation and anastomosis time, respectively; rho-factor ≥ 0.5; p < 0.05). In the multivariate regression analysis, EBL was determined to be a predictive factor for achieving postoperative urinary continence.
The study demonstrated that perioperative EBL is associated with postoperative urinary continence and oncologic outcomes after RARP.
本研究旨在评估机器人辅助根治性前列腺切除术（RARP）过程中围手术期估计失血量（EBL）与围手术期及术后参数之间的关系。
在这项回顾性研究中，分析了2012年12月至2024年8月期间接受RARP的局限性前列腺癌（PCa）患者的数据（n = 530）。EBL为100毫升或更少的患者被定义为第1组（n = 359），EBL超过100毫升的患者被定义为第2组（n = 166）。记录并比较两组的围手术期数据以及术后功能和病理结果。
第2组患者的淋巴结清扫时间、前列腺切除时间、吻合时间、总手术时间、引流管拔除时间和住院时间更长，EBL更大，手术切缘率更高，根据病理分期手术切缘阳性率更高，达到尿控的时间更长（p = 0.001）。术后第六个月的尿失禁（UI）评分无差异（p = 0.191）。观察到EBL与其他参数之间存在高度相关性（分别为引流管拔除时间、住院时间、达到尿控的时间、前列腺切除时间、术后第一个月和第三个月的国际尿失禁咨询问卷[ICIQ]总分以及总手术时间和吻合时间；rho系数≥0.5；p < 0.05）。在多变量回归分析中，EBL被确定为实现术后尿控的预测因素。
该研究表明，围手术期EBL与RARP术后的尿控和肿瘤学结果相关。
