攝護腺切片至達文西攝護腺切除手術時間間距與手術的相關性
賴建名12、吳振宇2、吳俊賢234、王強庭1、林嘉祥25
1國軍高雄總醫院外科部泌尿外科; 2義大醫院外科部泌尿外科; 3義守大學化學工程學系暨生物科技與化學工程研究所; 4義守大學醫學院護理學系; 5義守大學醫學院醫學系
Does the timing performing Robot-assisted laparoscopic Radical Prostatectomy (RARP) after prostate biopsy differ the outcomes?
Chien-Ming Lai1,2, Richard Chen-Yu. Wu2, Chun-Hsien Wu234, Chiang-Ting Wang1, Victor C. Lin25
1Divisions of Urology, Department of Surgery, Kaohsiung Armed Force General Hospital, Kaohsiung, Taiwan
2Divisions of Urology, Department of Surgery, E-Da Hospital, Kaohsiung, Taiwan
3Department of Chemical Engineering and Institute of Biotechnology and Chemical Engineering,
I-Shou University, Kaohsiung, Taiwan
4Department of Nursing, I-Shou University, Kaohsiung, Taiwan
5School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
Purpose:
Prostate biopsy induced prostate hemorrhage and peri-prostate tissue inflammation which raises the concern of increasing difficulty while performing Robot-assisted Radical Prostatectomy(RARP). To evaluate the correlation between outcomes and the interval after biopsy, we compared surgical outcomes in different time interval.
Materials and Methods:
We collected patient with localized disease without complicated status, e.g. status post transurethral resection of prostate(TURP) and nodal positive disease between 2016-2019 .There were 91 patients underwent RARP at a single institution. The patients were divided into 3 groups according to the time interval between prostate biopsy– RARP (≤4 weeks, 4-8 weeks and ≥ 8 weeks). Preoperative, perioperative and postoperative outcomes were collected and analyzed.
Results:
Regarding preoperative characteristics, there were similarities in the 3 groups. Concerning intraoperative outcomes, statistical difference was observed in mean estimated blood loss (244.4 vs. 158.4 vs. 168.9 ml, P = 0.048). Additionally, operative time was similar among 3 groups (219.2 vs. 250.7 vs. 223.9, P = 0.139). There was no difference in positive surgical margin rate among 3 groups. Longer time interval groups did not correlate to prolonged Foley-out days or hospitalization (all P>0.05). There was no difference in decreased erection hardness scores at 12 months between 3 groups (-0.67 vs. -0.73 vs. -0.43, P = 0.417).
Conclusions:
Performing RARP within 4 weeks after prostate biopsy did influence estimated blood loss, but did not appear to adversely influence operative time and postoperative outcomes.