基于倾向性评分匹配法的改良前列腺尖部分离技术联合腹腔镜前列腺癌根治术临床疗效观察  

Efficacy of modified prostate tip separation technique combined with laparoscopic radical prostatectomy based on propensity score matching

作　　者：赵志刚[1] 王克己[1] 杨杰[1] ZHAO Zhigang;WANG Keji;YANG Jie(Department of Urology,The Third People s Hospital of Anyang City,Anyang 455000,China)

机构地区：[1]安阳市第三人民医院泌尿外科,河南安阳455000

出　　处：《现代泌尿外科杂志》2023年第11期970-975,共6页Journal of Modern Urology

摘　　要：目的基于倾向性评分匹配法(PSM)分析改良的前列腺尖部分离技术联合腹腔镜前列腺癌根治术治疗前列腺癌的效果。方法选择2019年1月—2022年12月于安阳市第三人民医院泌尿外科行改良前列腺尖部分离技术联合腹腔镜前列腺癌根治术治疗的74例前列腺癌患者纳入联合组,另选取同期入院行腹腔镜前列腺癌根治术治疗的63例前列腺癌患者纳入对照组。经PSM匹配后,每组58例患者。比较匹配后两组患者的围术期指标、并发症发生率、术前及术后1个月控尿功能和性功能。结果匹配后两组各项基础资料的差异无统计学意义(P>0.05)。相较于术前,两组术后1个月国际尿失禁问卷简表(ICIQ-SF)、国际勃起功能问卷量表(IIEF-5)评分均降低(P<0.05),扩展前列腺癌复合指数量表(EPIC-UIN)、国际前列腺症状(IPSS)评分升高(P<0.05);且联合组ICIQ-SF[(9.02±1.98)分vs.(11.38±2.04)分]、IPSS[(19.67±4.19)分vs.(21.68±4.23)分]评分低于对照组,EPIC-UIN[(70.49±6.82)分vs.(63.34±6.48)分]、IIEF-5[(18.17±1.73)分vs.(16.72±1.58)分]评分高于对照组(P<0.05)。相较于对照组,联合组导管留置时间[(7.38±1.97)d vs.(5.11±1.82)d]、住院时间[(13.18±2.23)d vs.(11.74±2.09)d]更短,并发症发生率(22.41%vs.6.90%)更低,尖端切缘阳性率(8.62%vs.20.69%)更高(P<0.05)。结论PSM法可平衡组间差异,前列腺癌采用改良前列腺尖部分离技术联合腹腔镜前列腺癌根治术治疗可改善控尿功能,对性功能的影响小,术后并发症少,但尖部肿瘤切缘阳性风险较高,需进一步改良术式,以达到最佳疗效。Objective To explore the efficacy of modified prostate tip separation technique combined with laparoscopic radical prostatectomy based on propensity score matching(PSM)in the treatment of prostate cancer.Methods A total of 74 prostate cancer patients treated during Jan.2019 and Dec.2022 with modified prostate tip separation technique combined with laparoscopic radical prostatectomy were included in the combined group,and another 63 prostate cancer patients treated during the same period with laparoscopic radical prostatectomy were selected as the control group.Altogether 58 pairs of patients were matched with PSM.The perioperative indicators,incidence of complications,urinary control function and sexual function before and one month after surgery between the two groups after matching were compared.Results There were no statistically significant differences in general data between the two groups(P>0.05).One month after operation,the scores of the International Urinary Incontinence Questionnaire(ICIQ-SF)and International Erectile Function Questionnaire(IIEF-5)in both groups decreased,while the Expanded Prostate Cancer Index Composite(EPIC-UIN)and International Prostate Symptom Score(IPSS)in both groups increased(P<0.05).The scores of ICIQ-SF[(9.02±1.98)vs.(11.38±2.04)]and IPSS[(19.67±4.19)vs.(21.68±4.23)]were lower in the combined group than in the control group(P<0.05),while the scores of EPIC-UIN[(70.49±6.82)vs.(63.34±6.48)]and IIEF-5[(18.17±1.73)vs.(16.72±1.58)]were higher in the combined group than in the control group(P<0.05).Compared with the control group,the combined group had shorter catheter retention time[(7.38±1.97)d vs.(5.11±1.82)d]and hospital stay[(13.18±2.23)d vs.(11.74±2.09)d],lower incidence of complications(22.41%vs.6.90%),and higher positive rate of incision margin(8.62%vs.20.69%)(P<0.05).Conclusion PSM can balance the differences between groups.The modified prostate tip separation technique combined with laparoscopic radical prostatectomy can improve the urinary control function,hav

关 键 词：倾向性评分匹配法 改良前列腺尖部分离技术 腹腔镜前列腺癌根治术 控尿功能 性功能 肿瘤切缘阳性率 

分 类 号：R737.25[医药卫生—肿瘤]