| Objective:To investigate the Transurethral Resection of the Prostate(Transurethral Resection of the Prostate,TURP)line sporadic Prostate cancer after Laparoscopic Radical Prostatectomy,Laparoscopic Radical Prostatectomy,LRP)on perioperative parameters,the influence of the prognosis of oncology and urinary continence,and further studies to affect the postoperative biochemical recurrence of Prostate cancer may be risk factors.Methods: We retrospectively analyzed the clinical data of 163 male patients receiving LRP treatment in our department from January 2014 to December2017.Among them,37 patients had received TURP treatment before surgery(TURP group),and all of them were operated by plasma electrotomy system.In addition,58 patients without statistical differences in age,body mass index,serum prostate-specific antigen(PSA)level and preoperative Gleason score were selected as the control group.None of them had received TURP,but they were directly treated with LRP after diagnosis,and then the two groups of patients were compared and analyzed.Correlation statistics was used to compare the perioperative parameters,tumor prognosis and urinary control between the two groups.Univariate and multivariate regression analysis were used to study the independent risk factors of postoperative biochemical recurrence in patients with prostate cancer.Results: There were no statistically significant differences between the two groups in age,body mass index,serum prostate-specific antigen(PSA)level and preoperative Gleason score.Compared with the control group,TURP group had more blood loss(305.4 118.5 vs.137 91.3ml,P < 0.05),longer operation time(216.7 65.3 vs.145.252.3 min,P < 0.05),higher transfusion probability(5.4% vs.0%,P=0.037),and higher complication rate(43.2% vs.13.7%,P < 0.05).The positive surgical margin rate of TURP group was higher than that of control group(35.1% vs.24.1%),but the difference was not statistically significant(P = 0.353).At 3 months after surgery,the urinary continence rate of TURP group was lower(40.5% vs.70.7%,P=0.010),but at12 months after surgery,the urinary continence rate was similar(86.5% vs.94.6%,P=0.183),and the difference was not statistically significant.Postoperative gross pathological results indicated that p T2,p T3 and p T4 stages accounted for 75.7%,18.9%,5.4%,83.8%,8.1%,and 8.1% respectively in the TURP group and the control group,with no statistically significant difference between the two groups(P=0.217).After an average follow-up of 24.5 months,10.8% and 8.6% of patients in the TURP group and control group presented biochemical recurrence,respectively,with no statistically significant difference(P=0.661).Univariate and multivariate regression analysis indicated that the independent risk factors for postoperative biochemical recurrence of prostate cancer patients were PSA level(P=0.010)and positive condition of the incisal margin(P=0.029),while other relevant parameters were all P > 0.05,which was not statistically significant.Conclusion: After TURP,LRP is significantly more difficult to treat incidences of prostate cancer,but LRP is still feasible and safe.Although after TURP,LRP requires longer operation time,more blood loss,higher incidence of complications and poorer short-term urine control ability,the efficacy of LRP is definite,and its long-term tumor control effect is good,and there is no statistical difference in long-term urine control rate between the two groups.Through regression analysis of the factors that may affect the biochemical recurrence after prostate cancer surgery,it is found that PSA level and positive resection margin are independent risk factors for the biochemical recurrence after prostate cancer surgery,but it still needs to be confirmed by multi-center and large sample prospective clinical studies. |
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