Predictors Of Operative Time During Laparoscopic Prostatectomy And Establishment Of Nomogram

Objective: To explore the related factors affecting the operation time of laparoscopic radical prostatectomy in order to accurately predict the time of LRP operation before operation,improve the efficiency of perioperative period and reduce the cost of treatment.Methods and materials: a total of 273 patients undergoing laparoscopic radical prostatectomy from January 2013 to December 2017 in our department of urology were retrospectively analyzed.The age,hypertension,diabetes,body mass index(BMI),prostate volume,total prostatic specific antigen(t PSA),preoperative puncture pathological Gleason score,preoperative history of abdominal surgery,prostate penetration of the bladder(IPP),prostate post pubis interspace(Retzius space)cross sectional area ratio,sciatic bone ratio,and sciatic bone The narrowest distance between the spines(ISD),the maximum distance between the pelvic exportation of the sciatic tubercle(ITD),the anterior and posterior diameter of the pelvis(MAD),the anterior and posterior diameter of the pelvis(OAD),the depth of the prostatic apex(PAD),the surgical approach,the planned operation of the pelvic lymph node dissection,the planned preservation of the neurovascular bundle(NVP),and the operation.Between.Multi factor linear regression analysis was used to determine the prognostic factors of laparoscopic radical prostatectomy,and the regression coefficient was drawn according to the regression coefficient of the group variables.Results: Among the 251 patients,the operation time of the intraperitoneal approach and extraperitoneal approach group were(165.16 + 41.53)min and(142.15 + 41.32)min(P < 0.002),and the operation time of the lymph node dissection group and the non lymph node dissection group were(171.97 + 48.98)min and(134.85 + 35.35)min(P < 0.001),and NVP was retained.The operation time of group and non reserved NVP group were(159.23 + 41.28)min and(143.85 + 35.35)min,(P < 0.011),and the average operating time of each year from 2013 to 2017 was(153.35 + 35.24)min,(152.15 + 38.24)min,(151.15 + 43.27)min,(150.22 + 143.85)min,)min,.Multi factor linear regression analysis showed that BMI,prostate volume,prostate penetration(IPP),Retzius space transverse area ratio,pelvic lymph node dissection,preservation of neurovascular bundle,and intraperitoneal approach were the pretest factors for prolonging the operation time(P < 0.05).Conclusion: BMI,the volume of the prostate,the degree of the prostatic invasion of the bladder(IPP),the ratio of the transverse area of the prostate to the posterior space of the pubis(Retzius space),the planned pelvic lymph node dissection,the planned preservation of the neurovascular bundle,and the intraperitoneal approach are the predictors of the prolongation of the operation time.The time of operation is helpful to evaluate the difficulty of operation and improve the efficiency of perioperative period.