前列腺癌根治术中前列腺尖部及膀胱颈精准解剖与重建对尿控改善的影响
目的 探讨前列腺癌根治术中行前列腺尖部及膀胱颈尿道精准解剖与重建对术后尿控改善的影响.方法 回顾性选取2023年1月1日-2023年12月31日在本中心行机器人辅助前列腺癌根治术的随访资料完善的前列腺癌患者131例,其中64例研究组使用改良手术方式,67例对照组为传统手术方式.采用倾向性评分匹配法,按照1:1的比例匹配两组的年龄、体质量指数(body mass index,BMI)、术前前列腺特异抗原(prostate specific antigen,PSA)、前列腺体积、前列腺影像报告和数据系统(Prostate Imaging Reporting and Data System,PI-R...
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| Published in | 四川大学学报（医学版） Vol. 55; no. 5; pp. 1092 - 1098 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
泌尿男科疾病研究与医学转化安徽省重点实验室(合肥 230022)
20.09.2024
安徽医科大学第一附属医院泌尿外科(合肥 230022)%安徽医科大学第一附属医院泌尿外科(合肥 230022) 安徽医科大学泌尿外科研究所(合肥 230022) |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1672-173X |
| DOI | 10.12182/20240960502 |
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| Abstract | 目的 探讨前列腺癌根治术中行前列腺尖部及膀胱颈尿道精准解剖与重建对术后尿控改善的影响.方法 回顾性选取2023年1月1日-2023年12月31日在本中心行机器人辅助前列腺癌根治术的随访资料完善的前列腺癌患者131例,其中64例研究组使用改良手术方式,67例对照组为传统手术方式.采用倾向性评分匹配法,按照1:1的比例匹配两组的年龄、体质量指数(body mass index,BMI)、术前前列腺特异抗原(prostate specific antigen,PSA)、前列腺体积、前列腺影像报告和数据系统(Prostate Imaging Reporting and Data System,PI-RADS)评分、穿刺Gleason评分、术前尿控情况等资料.匹配后比较两组患者的术前基线资料、手术切缘阳性率、术后3个月时的尿控情况等资料.手术前后尿控情况的评估均采用术前国际尿失禁咨询问卷简表(International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form,ICIQ-UI SF)量表.结果 通过1:1倾向性评分匹配,研究组和对照组共成功匹配56对患者.术后3个月时,研究组ICIQ-UI SF量表得分中位数为7.0分,对照组ICIQ-UI SF量表得分中位数为9.5分,差异有统计学意义(P＜0.05);研究组和对照组切缘阳性率差异无统计学意义.多重线性回归分析发现,研究组中前列腺体积和Gleason评分均与术后3个月时ICIQ-UI SF评分呈正相关(P＜0.05),对照组中患者年龄与术后3个月时ICIQ-UI SF评分呈正相关(P＜0.05).结论 前列腺癌根治术中对前列腺尖部及膀胱颈尿道精准解剖与重建可明显改善术后3个月时患者尿控功能. |
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| AbstractList | 目的 探讨前列腺癌根治术中行前列腺尖部及膀胱颈尿道精准解剖与重建对术后尿控改善的影响.方法 回顾性选取2023年1月1日-2023年12月31日在本中心行机器人辅助前列腺癌根治术的随访资料完善的前列腺癌患者131例,其中64例研究组使用改良手术方式,67例对照组为传统手术方式.采用倾向性评分匹配法,按照1:1的比例匹配两组的年龄、体质量指数(body mass index,BMI)、术前前列腺特异抗原(prostate specific antigen,PSA)、前列腺体积、前列腺影像报告和数据系统(Prostate Imaging Reporting and Data System,PI-RADS)评分、穿刺Gleason评分、术前尿控情况等资料.匹配后比较两组患者的术前基线资料、手术切缘阳性率、术后3个月时的尿控情况等资料.手术前后尿控情况的评估均采用术前国际尿失禁咨询问卷简表(International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form,ICIQ-UI SF)量表.结果 通过1:1倾向性评分匹配,研究组和对照组共成功匹配56对患者.术后3个月时,研究组ICIQ-UI SF量表得分中位数为7.0分,对照组ICIQ-UI SF量表得分中位数为9.5分,差异有统计学意义(P＜0.05);研究组和对照组切缘阳性率差异无统计学意义.多重线性回归分析发现,研究组中前列腺体积和Gleason评分均与术后3个月时ICIQ-UI SF评分呈正相关(P＜0.05),对照组中患者年龄与术后3个月时ICIQ-UI SF评分呈正相关(P＜0.05).结论 前列腺癌根治术中对前列腺尖部及膀胱颈尿道精准解剖与重建可明显改善术后3个月时患者尿控功能. |
| Abstract_FL | Objective To investigate the impact of the precise dissection and reconstruction of the prostate apex and bladder neck urethra during radical prostatectomy on the improvement in postoperative urinary control in patients with prostate cancer.Methods A retrospective study was conducted.A total of 131 prostate cancer patients who underwent robot-assisted radical prostatectomy at our institution between January 1,2023 and December 31,2023 were enrolled.The subjects were divided into two groups,with 64 in the experimental group and 67 in the control group.Patients in the experimental group underwent radical prostatectomy in a modified approach,while those in the control group underwent conventional radical prostatectomy.Propensity score matching was employed to match the two groups at a 1-to-l ratio based on age,body mass index(BMI),preoperative prostate specific antigen(PSA),prostate volume,Prostate Imaging Reporting and Data System(PI-RADS)scores,biopsy Gleason score,and preoperative urinary control status.After matching,we compared the preoperative baseline data,surgical margin positivity rates,and urinary control status at 3 months post operation between the two groups.Urinary control was assessed before and after surgery using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form(ICIQ-UI SF)scale.Results A total of 56 pairs of patients were successfully matched between the experimental group and the control group through 1-to-l propensity score matching.At 3 months after surgery,the median score for ICIQ-SF scale of the experimental group was 7.0 points,while that of the control group was 9.5 points,with the difference being statistical significant(P＜0.05).There was no significant difference in the positive rate of incision margins between the experimental group and the control group.Multiple linear regression analysis showed that both the prostate volume and the Gleason score in the experimental group were positively correlated with the ICIQ-UI SF scores 3 months after surgery(P＜0.05),while the age of patients in the control group was positively correlated with ICIQ-UI SF score 3 months after surgery(P＜0.05).Conclusion Precise dissection and reconstruction of the prostate apex and bladder neck urethra during radical prostatectomy significantly improve the postoperative urinary control of patients at 3 months after surgery. |
| Author | 陈金虎 梁朝朝 施浩强 王雨帆 周骏 邰胜 杨诚 |
| AuthorAffiliation | 安徽医科大学第一附属医院泌尿外科(合肥 230022)%安徽医科大学第一附属医院泌尿外科(合肥 230022);安徽医科大学泌尿外科研究所(合肥 230022);泌尿男科疾病研究与医学转化安徽省重点实验室(合肥 230022) |
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| Author_FL | TAI Sheng YANG Cheng ZHOU Jun CHEN Jinhu SHI Haoqiang WANG Yufan LIANG Chaozhao |
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| DocumentTitle_FL | Effect of Precise Dissection and Reconstruction of the Prostate Apex and Bladder Neck in Radical Prostatectomy on Urinary Control Improvement |
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| Keywords | Reconstruction Urinary control 精准解剖 尿控 Radical prostatectomy 前列腺癌根治术 Precise dissection 重建 |
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