應用新型術前風險評分工具於機器手臂根除性攝護腺切除術後有無術後腸阻塞之患者

游家豪¹、林雍偉^1,2

¹臺北市立萬芳醫院泌尿科－委託財團法人臺北醫學大學辦理

²臺北醫學大學泌尿學科

Application of a Novel Preoperative Risk Score in Patients With and Without Postoperative Ileus after Robotic Radical Prostatectomy

Chia-Hao You¹, Yung-Wei Lin¹²

¹ Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.

² Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

Purpose: To evaluate the feasibility of applying the preoperative risk score proposed by Sabri et al. for predicting postoperative ileus (POI) after robotic-assisted radical prostatectomy (RARP) and to compare findings between POI and non-POI patients.

Methods: Sixteen consecutive RARP cases performed by a single surgeon were retrospectively analyzed. Preoperative variables including body mass index (BMI ≥31 kg/m²), HbA1c (≥8.0%), clinical T stage (≥T3), PI-RADS (≥4), prostate volume (>40.9 mL), and biopsy Gleason score (≥4+3) were scored (0 or 1). The sum (0–6) constituted the total preoperative risk score. Postoperative course, POI onset, and hospital stay were reviewed.

Results: Four patients (25%) developed POI on postoperative day 2–4. Their mean total score was higher than that of the non-POI group (2.8 vs 1.6). PI-RADS ≥4 and Gleason ≥4+3 were more prevalent in the POI group, suggesting an association between oncologic aggressiveness and intestinal dysmotility. The patient with the highest score (4) experienced the longest hospitalization (23 days).

Conclusions: The Sabri et al. preoperative risk score can be readily applied in real-world clinical settings. Higher risk scores and adverse tumor characteristics may predispose to POI after RARP. This model could serve as a useful tool for preoperative risk stratification, pending validation in larger prospective cohorts.