Obezitenin ekstraperitoneal laparoskopik radikal prostatektomi sonuçlarına etkisi

Abstract

Amaç: Bu çalışmada obezitenin ekstraperitoneal laparoskopik radikal prostatektomi (LRP) yapılan hastalarda perioperatif ve fonksiyonel sonuçlara etkisini değerlendirmeyi amaçladık.
Gereç ve yöntem: Etik kurul onayı alındıktan sonra Nisan 2014-Haziran 2018 tarihleri arasında lokalize prostat kanseri nedeniyle ekstraperitoneal LRP yapılan hastaların verileri retrospektif olarak incelendi. Takip süresi 12 aydan kısa olan, takipten çıkan, preoperatif hormonoterapi alan, pelvik cerrahi veya radyoterapi öyküsü olan ve verileri eksik olan hastalar çalışma dışı bırakıldı. Hastaların demografik dataları, perioperatif bulgular, patoloji sonuçları ve takiplerdeki onkolojik ve fonksiyonel sonuçlar kaydedildi. VKİ ≥30 kg/m² olan hastalar obez gruba dahil edildi.
Bulgular: Çalışmaya toplamda 160 hasta dahil edildi. Obez grubunda 64 hasta, obez olmayan grupta ise 96 hasta mevcuttu. Obez grubundaki 64 hastanın yaş ortalaması 66,06±5,6, obez olmayan gruptaki 96 hastanın yaş ortalaması ise 66,74±5,2 idi. Preoperatif IIEF skorları obez hasta grubunda anlamlı olarak daha düşüktü. Her iki grup, yaş, PSA, CCI, biyopsi GS, klinik evre, intraoperatif ve postoperatif komplikasyonlar açısından benzer özelliklere sahipti. Ayrıca iki grup, postoperatif onkolojik sonuçlar, biyokimyasal rekürrens, kontinans ve IIEF skorlarındaki düşüş açısından karşılaştırıldığında anlamlı fark gözlenmedi.
Sonuç: Prostat kanserli obez hastalarda ekstraperitoneal LRP, benzer onkolojik ve fonksiyonel sonuçlarla uygulanabilen, güvenli ve etkili bir tedavi metodu olarak görünmektedir.

Keywords

• Prostat kanseri
• ekstraperitoneal yaklaşım
• laparoskopik radikal prostatektomi
• obezite

The impact of obesity on the outcomes of extraperitoneal laparoscopic radical prostatectomy

Abstract

Objective: In this study, we aimed to evaluate the impact of obesity on perioperative and functional outcomes in patients who underwent extraperitoneal LRP.
Material and methods: After the approval of the ethics committee, the data of patients who underwent extraperitoneal LRP between April 2014 and June 2018 for localized prostate cancer were analyzed retrospectively. Patients with follow-up period of less than 12 months, who were out of follow-up, who received preoperative hormonal therapy, who had a history of pelvic surgery or radiotherapy, and whose data were missing were excluded from the study. Demographic data, perioperative findings, pathology results and oncological and functional results in follow-up were recorded. Patients with BMI ≥30 kg/m² were included in the obese group.
Results: A total of 160 patients were included in the study. There were 64 patients in the obese group and 96 patients in the non-obese group. The mean age of 64 patients in the obese group was 66.06±5.6, and the mean age of 96 patients in the non-obese group was 66.74±5.2. Preoperative IIEF scores were significantly lower in the obese patient group. Both groups had similar characteristics in terms of age, PSA, CCI, biopsy GS, clinical stage, intraoperative and postoperative complications. In addition, when the two groups were compared in terms of postoperative oncological outcomes, biochemical recurrence, continence, and decrease in IIEF scores, no significant difference was observed.
Conclusions: LRP seemed safe and effective in obese patients, with similar onncological outcomes, functional outcomes, complication rates and continence rates to normal weight patients.

Keywords

• Prostat cancer
• extraperitoneal approach
• laparoscopic radical prostatectomy
• obesity

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