腹腔镜腹膜外前列腺癌根治术围手术期并发症的影响因素分析

Analysis of the influencing factors of perioperative complications in patients undergoing extraperitoneal laparoscopic radical prostatectomy

目的:回顾性分析接受腹腔镜腹膜外前列腺癌根治术(extraperitoneal laparoscopic radical prostatectomy,ELRP)患者的临床和随访资料,总结分析ELRP围手术期并发症的影响因素。方法:回顾性分析2017年1月~2018年12月在我院接受ELRP患者的临床资料和随访资料,根据纳入、排除标准进行筛选出216例入组患者。详细记录患者的一般情况、BMI、术前Gleason评分、病理T分期、淋巴结清扫个数、手术经验、术中出血量、术中输血量、围手术期病理T分期、围手术期Gleason评分情况等。通过对各组患者数据进行单因素分析和多因素Logistic回归分析筛选出影响患者围手术期并发症的因素。结果:将BMI、围手术期Gleason评分、病理T分期、淋巴结清扫个数、手术经验、临床T分期、术前Gleason评分共7个变量纳入Logistic回归分析。最后得出BMI(X1)、围手术期Gleason评分(X4)、病理T分期(X5)、手术经验(X7),OR系数分别为1.165、2.721、3.930、2.122。Logistic回归方程分析结果表明BMI、围手术期Gleason评分、病理T分期、手术经验是影响围手术期并发症的5个独立危险因素。结论:BMI、围手术期Gleason评分、病理T分期、手术经验均可影响ELRP围手术期并发症发生情况。调控前列腺患者体内的内分泌状态、增加手术经验各项参数可能有助于减低ELRP围手术期并发症。

Objective: To retrospectively analyze the influencing factors of perioperative complications in patients undergoing extraperitoneal laparoscopic radical prostatectomy(ELRP). Method: The clinical and follow-up data of patients receiving ELRP in our hospital from January 2017 to December 2018 were analyzed retrospectively, and 216 patients were selected according to the inclusion and exclusion criteria. The general condition, BMI, preoperative Gleason score, pathological T stage, number of lymph node dissection, surgical experience, intraoperative blood loss, intraoperative blood transfusion, perioperative pathological T stage and perioperative Gleason score were recorded in detail. Through univariate analysis and multivariate logistic regression analysis, the factors influencing perioperative complications were screened out. Result: Seven variables including BMI, perioperative Gleason score, pathological T stage, number of lymph node dissection, surgical experience, clinical T stage and preoperative Gleason score were included in logistic regression analysis. At last, BMI(X1), perioperative Gleason score(X4), pathological T stage(X5) and surgical experience(X7) were obtained. Or coefficients were 1.165, 2.721, 3.930 and 2.122, respectively. The results of logistic regression analysis showed that BMI, perioperative Gleason score, pathological T stage and surgical experience were the five independent risk factors of perioperative complications. Conclusion: BMI, perioperative Gleason score, pathological T stage and surgical experience can influence the occurrence of perioperative complications of ELRP. It may be helpful to reduce the perioperative complications of ELRP by regulating the endocrine state of patients and increasing the parameters of surgical experience.