Three-dimensional Reconstruction Of Prostate Tumor For Prostate Cancer Puncture And Surgery

Objectives By comparing and analyzing the curative effect difference between 3D reconstruction of prostate assisted laparoscopic radical prostatectomy(LRP)and traditional laparoscopic radical prostatectomy,evaluating its feasibility and safety,and then discussing the effect of 3D reconstruction of prostate tumor on prostate cancer surgery guiding significance.Methods A total of 80 patients with radical prostatectomy who were admitted to the Department of Urology,North China University of Technology Affiliated Hospital from March 2018 to April 2021 were retrospectively analyzed.They were divided into 2 groups according to different surgical methods.Among them,43 patients in the traditional laparoscopic surgery group and three-dimensional Thirty-seven patients in the reconstruction-assisted laparoscopic radical prostatectomy group were referred to as the traditional group and the three-dimensional group for short.The clinical data and case data of these patients were collected,including the patient’s age,BMI,PSA,prostate volume,preoperative Gleason score,postoperative Gleason score,clinical stage,case stage,operation time,intraoperative blood loss,urethral reconstruction time,Pelvic drainage tube extraction time,urinary catheter extraction time,surgical complications,the number of patients with positive surgical margins,the number of patients with biochemical recurrence rate,the number of postoperative hospitalization days,hospitalization costs,postoperative urinary continence recovery rate,and the number of patients with erectile dysfunction.The independent samples t test was used for comparison between the two groups,and the chi-square test was used for the comparison of counting treatment,such as the positive rate of surgical margins.In order to explore whether the three-dimensional reconstruction of prostate tumor has certain guiding significance for prostate surgery.Results Among the 80 patients,43 in the traditional laparoscopy group and 37 in the three-dimensional laparoscopy group successfully completed the operation.The mean age of the traditional group and the three-dimensional group was(69.49±7.65Y VS68.89±6.67Y,P>0.05);the mean BMI was(22.17±2.39kg/m~2 VS 22.02±1.96kg/m~2,P>0.05);the mean PSA was(14.92±11.52 ng/ml VS 14.41±9.64ng/ml,P>0.05);the mean volume was(54.77±21.18cm~3 VS 60.14±25.42cm~3,P>0.05);and the preoperative Gleason score,clinical The staging,postoperative Gleason score and pathological staging were statistically analyzed.All the above items were P>0.05.There was no significant statistical difference between the two groups of data,indicating that the two groups of data were comparable.In the traditional group and the three-dimensional group,the operation time(180.14±43.98min VS 152.08±30.66min,P<0.05);the intraoperative blood loss(192.57±73.34ml VS 162.54±54.83ml,P<0.05);the urethral reconstruction time(28.74±4.52min VS 26.70±3.04min,P<0.05);pelvic drainage tube extraction time(6.74±1.46d VS 5.81±1.59d,P<0.05);postoperative hospital stay(11.30±2.01d VS9.94±2.39d,P<0.05);in terms of the positive rate of surgical margins(37.2%VS 16.2%,P<0.05),the three-dimensional group had an advantage.In terms of catheter pull-out time(12.23±2.29d VS 11.89±2.43d,P>0.05);in hospitalization expenses(5.50±1.56￥VS5.44±1.38￥,P>0.05);in postoperative complications(14.0%VS 10.8%,P>0.05);3-month biochemical recurrence rate(4.7%VS 2.7%,P>0.05).In the traditional group and the three-dimensional group,the immediate urinary continence rate(4.7%VS 21.6%,P<0.05),the urinary continence rate at 1 month after operation(32.6%VS 56.8%,P<0.05),and the 3 months after operation In terms of urinary continence rate(51.2%VS 81.8%,P<0.05),the above P values at immediate urinary continence,1 month and 3 months after operation were all less than 0.05,and the difference was statistically significant.It can be seen that the recovery rate of urinary continence in the three-dimensional group outperformed the traditional group.In terms of urinary continence rate 6 months after operation(74.4%VS 83.3%,P>0.05)and 12 months after operation(86.1%VS 91.9%,P>0.05),the P values were all greater than 0.05,the difference was Not statistically significant.In the traditional group and the three-dimensional group,the number of erectile dysfunction at 3 months after operation(67.4%VS 56.8%,P>0.05),and the number of erectile dysfunction at 6 months after operation(48.8%VS 32.4%,P>0.05),P values were greater than 0.05,the difference was not statistically significant.In the number of people with erectile dysfunction at 12 months after operation(39.5%VS 18.9%,P<0.05),the P value was less than 0.05,and the difference was statistically significant,indicating that the three-dimensional group was better than the traditional group for long-term erectile function recovery.Conclusions Three-dimensional reconstruction-assisted LRP surgery can reduce the difficulty of surgery,shorten the operation time,shorten the time of urethral reconstruction,reduce the amount of intraoperative blood loss,speed up the rapid recovery of the patient’s body after surgery,and enable the patient to pull out the pelvic drainage tube as soon as possible,shortening the hospitalization time,Improve the patient’s early continence ability and long-term sexual function recovery ability and other advantages,and improve the patient’s quality of life.In addition,the short-term oncological effects(positive margin rate and biochemical recurrence rate)of 3D reconstruction-assisted LRP surgery,and the prognosis were similar to those after LRP surgery.The changes in the long-term oncological control effect need further follow-up.In general,3D reconstruction-assisted LRP surgery is safe and feasible,with satisfactory clinical effects,and can be used in clinical practice.Figure 3;Table 5;Reference 102.