Analysis Of Positive Surgical Margins After Robot-assisted Laparoscopic Radical Prostatectomy

Objective:To study the positive margin of robotic assisted laparoscopic radical prostatectomyMethod:A retrospective selection of 71 patients undergoing robotic assisted laparoscopic radical prostatectomy in our department from 2017 to 2019 was performed by the same team.According to the positive margin of postoperative margin,the patients were divided into positive margin and negative margin.The ages were(71.04±7.351),(70.27±6.478) years old,and body mass index(BMI) were(24.29±4.259),(23.05).±3.968)kg/m2,the number of positive needles was(8.15±3.949),(8.43±4.747),and the prostate weight was(46.80±27.421 g) and(41.12±19.139g),respectively.The univariate analysis of patient age,BMI,puncture-positive needle number,and prostate weight was performed by t-test.The preoperative PSA,puncture Gleason score,clinical stage,and pathological staging were analyzed by x~2 test.The independent risk factors for positive margin were analyzed.Binary logistic regression analysis was used.The data was analyzed by using SPSS22.0.Result:Of the 71 patients,44(62%) were negative for pathological margin and 27(38%) were positive for margin,of which 6(22.2%) were positive in apex margin.4 cases(14.81%) were positive in bottom margin,3 cases(11.11%) were positive in the body margin,and 14 cases(51.85%) were positive in the multi-focal margin.Univariate analysis showed that preoperative Gleason score(P=0.028) and pathological stage(P=0.000) were positively correlated with margins.Multivariate logistic analysis showed that pathological stage(P=0.004) was an independent risk factor for positive margin.Conclusion:Pathological staging is an independent risk factor for positive margins in robot-assisted laparoscopic radical prostatectomy.The incidence of positive margins in the prostate apex and bottom margin is higher..Choosing the right patient to preserve the nerve’s surgical approach may be safe for oncology.