The Influence Factors Of Pelvic Parameters And Pathological Parameters On The Difficulty Of Laparoscopic Radical Resection Of Bladder Cancer

Objective: To evaluate the influencing factors of difficulty of laparoscopic radical cystectomy by measuring the diameter of pelvis and clinicopathologic parameters with preoperative CT.Methods: Study January 2018 By 2021,70 consecutive patients who underwent radical cystectomy were examined by three-dimensional images established by thinsection contrast-enhanced CT to measure the size of each diameter line of the pelvis.According to the parameters of each diameter line of the pelvis and basic data,the effects on the dependent operation time and intraoperative blood loss were judged.Univariate and multivariate analyses were performed for these parameters to screen out the factors that may affect the operation time and blood loss.Logistic multivariate analysis was performed on the selected risk factors,and the risk factors were assigned values according to the characteristics of logistic regression analysis to establish a scoring system.Finally,the receiver operating characteristic(ROC)was used to evaluate the efficacy of the scoring system,and the calibration curve was used to determine its prediction accuracy.Results: The anteroposterior diameter of the middle pelvis,the distance from the suprapubic bone to the coccyx,and the diameter of the spinous process of the middle pelvis are independent factors affecting the difficulty of the operation,and have a great influence on the difficulty of the operation.The results of ROC curve showed that Y0.83 could be used as the predictive value to determine the ease of laparoscopic cystectomy,and its sensitivity and specificity were 97.1% and 66.6%,respectively.Conclusion: Preoperative CT pelvis measurement can provide a useful index for evaluating the difficulty of laparoscopic radical cystectomy.