12点法前列腺穿刺活检术后2周内行腹腔镜前列腺根治性切除术的临床分析

Interval of ≤2 weeks between 12-core prostate biopsy and laparoscopic radical prostatectomy does not affect perioperative parameters or surgical outcomes

目的:探讨12点法穿刺后间隔2周内行腹腔镜前列腺根治性切除术对围手术期指标及手术结果的影响。方法:回顾性分析2012年1月至2016年12月经直肠前列腺12点穿刺活检后行腹腔镜前列腺根治性切除术患者102例。按照前列腺穿刺活检与手术的时间间隔(IT)分为≤2周、2周<IT≤6周、>6周3组。患者平均年龄为69.87(59~84)岁,平均体质量指数(BMI)24.99(15.62~33.14)kg/m2,术前平均PSA 24.41(0.41~111.78)μg/L,平均前列腺体积56.05(15.97~216.52)ml,平均Gleason评分7.51(6~9)分。记录并评估患者临床资料、围手术期指标及手术结果。结果:102例手术均成功完成,无中转开放手术。3组间患者年龄、BMI、术前PSA、前列腺体积、Gleason评分、T分期等临床资料差异均无统计学意义。3组间手术时间、术中出血量、输血率、肠道损伤、切缘阳性率、术后3个月控尿率等指标差异均无统计学意义。结论:12点法前列腺穿刺活检后2周内行腹腔镜前列腺根治性切除术安全有效,前列腺穿刺与手术的时间间隔并不影响围手术期指标及手术结果。

Objective： To determine whether a short interval （ ≤2 weeks） between 12-core prostate biopsy and laparoscopic radical prostatectomy （LRP） affects perioperative parameters and the outcome of surgery. Methods ： This retrospective study included 102 cases of prostate cancer treated by LRP after 12-core prostate biopsy from January 2012 to December 2016. Based on the interval between prostate biopsy and LRP, we divided the patients into three groups： ≤2 wk （n = 35）, 〉2 -6 wk （n = 21）, and 〉6 wk （n = 46）. The patients averaged 69.87 （59 - 84） years in age, 24.99 （ 15.62 - 33.14） kg/m2 in the body mass index （ BMI）, 24.41 （0.41 - 111.78）μg/L in the baseline PSA level, 56.05 （ 15.97 -216.52） ml in the prostate volume, and 7.51 （6 -9） in the Gleason score. We analyzed the clinical data, perioperative parameters and outcomes of surgery, and compared them among the three groups of patients. Results： Operations were completed successfully in all the 102 cases without transferring to open surgery. There were no statistically significant differences among the three groups of patients in age, BMI, baseline PSA level, prostate volume, Gleason score, or T stage, nor in the operation time, estimated intraoperative blood loss, blood transfusion rate, intestinal injury, posi- tive incision margin rate, or urinary continence rate at 3 months after surgery. Conclusion ： Laparoscopic radical prostatectomy at ≤ 2 weeks after 12-core prostate biopsy is safe and effective in the treatment of prostate cancer and does not affect the perioperativeparameters and outcomes of surgery.