糖尿病對接受機器人手臂攝護腺根除術病人的影響
侯鎮邦、潘柏諺、張慧朗、陳建綸、林友翔、楊珮珊、崔克宏
長庚醫療財團法人林口長庚紀念醫院 泌尿外科
The Impact of Diabetes Mellitus on Patients Receiving Robotic Assisted Radical Prostatectomy for Prostate Cancer
Chen-Pang Hou, Pai-Yen Pan, Phei-Lang Chang, Chien-Lun Chen, Yu-Hsiang Lin, Pei-Shan Yang, Ke-Hung Tsui.
Department of Urology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Purpose: The aim of this study was to compare the early clinical outcomes between diabetic patients and non-diabetic patients receiving robotic assisted radical prostatectomy for prostate cancer.
Materials and Methods: Records were obtained from a review of database for prostate cancer patients receiving robotic assisted radical prostatectomy of Chang-Gung Memorial Hospital, Taiwan, from January 2012 to December 2014. The patients underwent a detailed physical examination and medical history review and were divided into two groups: diabetic group and non-diabetic group. The preoperative variables, intraoperative and postoperative data were compared among the two groups. Their biochemical recurrence free survival and the urinary continence recovery were also taken into comparison.
Results: A total of 363 patients (84 DM; 279 non-DM) were enrolled in our study. Our data revealed that the patients of DM cohort were older in age (68 vs. 65 year old, p=0.002) and higher in BMI (26.2 vs. 24.8 kg, p=0.009). The DM cohort also had a higher percentage of clinical T3a (35.7% vs. 26.5%, p<0.001) and Gleason score 8-10 (26.2% vs.14.3%, p=0.019). Intraoperatively, the two groups were similar in regard to operative time, blood loss, hospital stay, transfusion rates, and surgical complication rates. However, the final pathology stage of the DM cohort seemed to be more advanced than that of the non-DM cohort. Although their biochemical recurrence free survivals were similar, the speeds of recovery from urinary incontinence were quite different. The continence rate of DM group over post-OP 3 months, 6 months, and 12 months were 30.9%, 45.0%, and 62.8%, respectively, while the non-DM group were 43.0%, 66.5%, and 94.9%, respectively ( p<0.001).
Conclusions: Among the prostate cancer patients receiving robotic assisted radical prostatectomy, the DM group had a more advanced T stage compared to the non-DM group. Their urinary continence also recovered more slowly.