Büyük prostat hacminin robotik radikal prostatektomi sonrası perioperatif, onkolojik ve fonksiyonel sonuçlar üzerine etkisi: Retrospektif klinik çalışma

Abstract

Amaç: Bu çalışmada büyük prostat volümünün Robot yardımlı radikal prostatektomi (RARP) uygulanan prostat kanserli hastalarda cerrahi, onkolojik ve fonksiyonel sonuçlara etkisinin değerlendirilmesini amaçladık. Gereç ve Yöntemler: Bu çalışmada prostat kanseri nedeniyle tek cerrah tarafından RARP uygulanan hastalar 75 cc’nin üzerinde büyük prostat hacmi (Grup-1) ve 75 cc’nin altında prostat hacmi (Grup-2) olmak üzere iki gruba ayrılmış ve bu iki grup retrospektif olarak karşılaştırılmıştır. Hastalar 12 aylık takip süresince değerlendirildi. Bulgular: Yaş, preoperatif PSA seviyesi, klinik evre dağılımları , Gleason skoru, D’Amico risk sınıflaması, cerrahi öncesinde potens ve kontinans değerlendirmesi açısından iki grup arasında anlamlı fark yoktu (p>0.05). Operasyon süresi grup 1 ve 2’de sırasıyla 169.9 ± 62.5 dakika ve 145.6 ± 56.1 dakika saptandı ve Grup 1’de anlamlı olarak daha yüksekti (p = 0.02). Grup 1 ve 2’de sırasıyla 17 (%35) ve 2 (%3) hastaya mesane boynu rekonstrüksiyonu yapıldı ve grup-1’de istatiksel anlamlı olarak yüksekti (p = 0.001). Grup 1 ve Grup 2’de üretral kateter çıkarıldıktan sonra tam kontinans ve potens oranları 1 yıllık takip süresince benzerdi (p > 0.05). 6. ay ve 1. yılda biyokimyasal nüks oranları Grup 1 ve Grup 2’de benzer izlendi (p > 0.05). Sonuç: Büyük prostat hacmine sahip prostat kanserli hastalarda RARP daha uzun operasyon süresi ile sonuçlanır ve mesane boynu rekonstruksiyonu gerekebilir. Ancak deneyimli cerrahlar tarafından gerçekleştirilen operasyonlarda büyük prostat hacminin cerrahi, fonksiyonel ve onkolojik sonuçlara olumsuz etkisi yoktur.

Keywords

• Robotik cerrahi işlemler
• Prostatektomi
• Prostat
• Organ Büyüklüğü

Effect of large prostate volume on perioperative, oncological and functional outcomes after robotic radical prostatectomy: A retrospective clinical study

Abstract

Objective: In this study, we aimed to evaluate the effect of large prostate volume on surgical, oncological and functional outcomes in prostate cancer patients who underwent Robot-assisted radical prostatectomy (RARP). Material and Methods: In this study, patients who underwent RARP due to prostate cancer by a single surgeon were divided into two groups as large prostate volume over 75 cc (Group-1) and prostate volume less than 75 cc (Group-2), and these two groups were compared retrospectively. Patients who were followed up for 12 months were assessed. Results: There was no significant difference between the two groups in terms of age, preoperative PSA level, clinical stage distributions, Gleason score, D’Amico risk classification, preoperative potency and continence assessment (p>0.05). The operative time was 169.9 ± 62.5 minutes and 145.6 ± 56.1 minutes in Groups 1 and 2, respectively, and was significantly higher in Group 1 (p= 0.02). Bladder neck reconstruction was performed in 17 (35%) and 2 (3%) patients in Groups 1 and 2, respectively, and it was statistically significantly higher in Group-1 (p=0.001). After removal of the urethral catheter in Group 1 and Group 2, full continence and potency rates were similar during the 1-year follow-up (p >0.05). Biochemical recurrence rates at 6 months and 1 year were similar in Group 1 and Group 2 (p >0.05). Conclusion: In prostate cancer patients with large prostate volume, RARP results in longer operative time and bladder neck reconstruction may be required.. However, in operations performed by experienced surgeons, large prostate volume does not have a negative effect on surgical, functional and oncological outcomes.

Keywords

• robotic surgical procedures
• prostatectomy
• prostate
• organ size
• Robotik cerrahi işlemler
• Prostatektomi

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