Does obesity affect the outcomes of clinically localized prostate cancer in the era of extraperitoneal robot-assisted radical prostatectomy?

IF 0.8 Q4 UROLOGY & NEPHROLOGY Urological Science Pub Date : 2022-07-01 DOI:10.4103/uros.uros_139_21
Mu-Chiao Tung, Chun-Hsien Wu, R. Wu, W. Kuo, Hsing-Chia Mai, Sih-Han Chen, C. Chiang, V. Lin
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Abstract

Purpose: Obesity has been proven to affect the outcomes in open radical prostatectomy. However, the relationship between obesity and the outcomes of robot-assisted radical prostatectomy (RARP) was not conclusive. Herein, we aimed to investigate the impact of obesity on the clinical outcomes after RARP. Materials and Methods: From April 2016 to June 2020, 164 patients underwent RARP by a single experienced surgeon at our institute. Patients with previous transurethral resection of prostate (n = 30), hernioplasty (n = 13), and transperitoneal RARP (n = 26) were excluded. Finally, 105 patients were enrolled and divided into different groups according to their body mass index (BMI) and waist circumference (WC) using the definition of Taiwan National Health Institute. BMI was categorized into three groups (normal: BMI <24, overweight: BMI between 24 and 27, and obese: BMI ≥27 [kg/m2]). WC was categorized into two groups (normal: WC <90 and central obesity: WC ≥90 [cm]). Perioperative outcomes and functional outcomes including preoperative, postoperative erectile function, and postoperative continence status were evaluated. Results: Among BMI groups, 29 patients were normal, 43 patients were overweight, and 33 patients were obese. Console time and sum time showed a significant difference in different BMI groups (P = 0.034 and 0.016, respectively). Of the 101 patients with available magnetic resonance imaging, 74 patients' WC were normal, and 27 patients were central obese. Blood loss in central obesity group was significant more than normal WC group (300 ml vs. 200 ml, P = 0.04). No significant differences were observed in pathological and functional outcomes in both groups. Conclusion: Obesity and central obesity seemed to result in longer operation time and more blood loss in extraperitoneal RARP while functional outcomes can be maintained regardless of the obesity degree. Large-scale studies are necessary to further explore the relationship between obesity and the outcomes of RARP in future.
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在腹膜外机器人辅助根治性前列腺切除术时代,肥胖是否影响临床局限性前列腺癌的预后?
目的:肥胖已被证实会影响开放性根治性前列腺切除术的预后。然而,肥胖与机器人辅助根治性前列腺切除术(RARP)结果之间的关系尚无定论。本研究旨在探讨肥胖对RARP术后临床结果的影响。材料与方法:2016年4月至2020年6月,我院由一名经验丰富的外科医生对164例患者行RARP手术。排除既往经尿道前列腺切除术(n = 30)、疝成形术(n = 13)和经腹腔RARP (n = 26)的患者。最后,以105名患者为研究对象,依据体质指数(BMI)及腰围(WC),采用台湾国立卫生研究院的定义,分为不同的组。BMI分为3组(正常:BMI <24,超重:BMI在24 ~ 27之间,肥胖:BMI≥27 [kg/m2])。WC分为正常组(WC <90)和中心性肥胖组(WC≥90 [cm])。评估围手术期结局和功能结局,包括术前、术后勃起功能和术后尿失禁状态。结果:BMI组中,正常29例,超重43例,肥胖33例。不同BMI组间治疗时间、总时间差异有统计学意义(P = 0.034、0.016)。101例磁共振成像患者中,74例WC正常,27例中心性肥胖。中心性肥胖组失血量显著高于正常WC组(300 ml vs 200 ml, P = 0.04)。两组的病理和功能结果均无显著差异。结论:肥胖和中心性肥胖似乎导致腹膜外RARP手术时间更长,出血量更多,但无论肥胖程度如何,功能结局均可维持。未来需要大规模的研究来进一步探讨肥胖与RARP结果之间的关系。
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来源期刊
Urological Science
Urological Science UROLOGY & NEPHROLOGY-
CiteScore
1.20
自引率
0.00%
发文量
26
审稿时长
6 weeks
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