Effect of pelvimetric diameters on success of surgery in patients submitted to robot-assisted perineal radical prostatectomy

ABSTRACT Objective: Minimally invasive techniques are used increasingly by virtue of advancements in technology. Surgery for prostate cancer, which has high morbidity, is performed with an increasing momentum based on the successful oncological and functional outcomes as well as cosmetic aspects. Materials and methods: Sixty two patients underwent robot-assisted perineal radical prostatectomy (R-PRP) surgery at our clinic between November 2016 and August 2017. Six pelvimetric dimensions were defined and measured by performing multiparametric magnetic resonance imaging (mpMRI) prior to operation in all patients. In light of these data, we aimed to investigate the effect of pelvimetric measurements on surgery duration and surgical margin positivity. Results: By using this technique in pelvic area, we observed that measurements only representing surgical site and excluding other pelvic organs had a significant effect on surgery duration, and pelvic dimensions had no significant effect on surgical margin positivity. Conclusion: In R-PRP technique, peroperative findings and oncological outcomes can vary depending on several variable factors, but although usually not taken into account, pelvimetric measurements can also affect these outcomes. However, there is a need for randomised controlled trials to be conducted with more patients.

摘要 目的：随着技术进步，微创技术的应用日益广泛。前列腺癌手术虽并发症发生率较高，但凭借优异的肿瘤学、功能学疗效及美观性表现，其应用热度持续攀升。材料与方法：2016年11月至2017年8月间，本临床中心共有62名患者接受机器人辅助经会阴根治性前列腺切除术（robot-assisted perineal radical prostatectomy, R-PRP）。所有患者术前均接受多参数磁共振成像（multiparametric magnetic resonance imaging, mpMRI），并测定了6项骨盆测量维度。基于上述数据，本研究旨在探讨骨盆测量参数对手术时长及手术切缘阳性率的影响。结果：针对盆腔区域应用该术式后，我们观察到仅反映手术部位、未纳入其他盆腔器官的测量指标对手术时长存在显著影响，而骨盆整体维度对手术切缘阳性率无显著影响。结论：在R-PRP术式中，术中所见及肿瘤学结局受多种可变因素影响；尽管通常未被纳入考量范畴，但骨盆测量参数亦可对上述结局产生影响。不过，未来仍需纳入更多患者开展随机对照试验以进一步验证相关结论。