Comparative Analysis Of The Influence Of TURP History On RARP Surgery In Patients With Prostate Cancer

Objective:Provide preliminary reference for RARP surgery and treatment in patients with prostate cancer who have a history of TURP.Methods:A retrospective analysis of 202 cases of robot-assisted laparoscopic radical prostatectomy was performed in our hospital from January 1,2015 to December 31,2017.A total of 183 patients were enrolled after strict screening.The perioperative related indexes,postoperative oncology and functional findings were compared between the two groups(31 cases in group A had a history of resection for the prostate and 152 cases in group B had no history of resection for the prostate).Specific research indicators include: age,body mass index,PSA,prostate size,Gleason score,risk factor grade,operation time,intraoperative blood loss,blood transfusion rate,rectal injury number,margin positive rate,seminal vesicle involvement rate,postoperative pathology Gleason score,complication rate,postoperative hospital stay,postoperative indwelling catheter time,postoperative indwelling drainage tube time,postoperative PSA,postoperative urinary incontinence,postoperative recurrence(1 month,3 months,half year,One year).To investigate whether previous TURP affects the oncological safety,functional effects,and complication rate of RARP.Results:The mean age(years)of the A/B group were 67.3±5.2,68.4±5.6,P=0.347,which was not statistically significant;The mean body mass index(kg/m2)of the A/B group were 23.6±2.5,23.2±2.4,P=0.389,which was not statistically significant;The median values of preoperative tPSA(ng/ml)in the A/B group were 27.5(0.1-67.1),38.9(3.8->200),P=0.222,which was not statistically significant;The median values of prostate size(g)in the A/B group were 33.1(10.7-62.1),39.8(18.5-128.6),P=0.020,which was statistically significant;The median values of Gleason scores in the A/B groups were 6(4-10),7(4-10),P=0.694,which was not statistically significant;The mean time of RARP operation time(min)in A/B group were 247.6±62.3,191.8±57.7,P<0.001,which was statistically significant.The mean blood loss(ml)of A/B group were 235.6±144.6,180.9±112.7,P=0.021,which was statistically significant;the incidence of postoperative complications in the A/B group were 5(16.1%),5(3.3%),P=0.004,which was statistically significant;The postoperative hospital stay(days)in the A/B group were 10.4±5.5,8.5±3.3,P=0.011,which was statistically significant.The indwelling catheter time(days)of A/B group were 15.8±5.0,13.2±4.2,P=0.003,which was statistically significant;The drainage tube indwelling time(days)in the A/B group were 5.6±2.5,4.8±2.4,P=0.101,which was not statistically significant;Conclusions:1.Patients with prostate cancer who have a history of TURP surgery are feasible and safe,but have higher operative time and intraoperative blood loss.However,overall controllable,although postoperative complications,long hospital stays,and urinary control may be worse.2.When the patients with prostate cancer who have a history of TURP surgery choose RARP,the interval between the two operations for 2 months and more may be better than 1 month,which does not affect the postoperative recovery and quality of life after surgery.3.The risk of RARP in high-risk prostate cancer patients with a history of TURP surgery is higher than that of low-risk and intermediate-risk patients.The risk of RARP is increased,but it is still a safe and reliable option.It is necessary to choose experienced senior doctors.