Nerve-sparing approach during radical prostatectomy is strongly associated with the rate of postoperative urinary continence recovery
Nerve-sparing approach during radical prostatectomy is strongly associated with the rate of postoperative urinary continence recovery
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DOI：
10.1111/j.1464-410x.2012.11315.x
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发表时间：
2013-05-01
影响因子：
4.5
通讯作者：
Briganti, Alberto
中科院分区：
文献类型：
--
作者：
Suardi, Nazareno;Moschini, Marco;Briganti, Alberto
目的研究神经保留根治性前列腺切除术（NSRP）与非神经保留根治性前列腺切除术相比，可提高器官局限性前列腺癌患者的尿失禁（UC）恢复率。患者和方法本研究纳入2003年至2010年间接受根治性前列腺切除术的1249例患者。患者被分为三个术前危险组：低（PSA < 10 ng/mL, cT1，活检Gleason sum 20 ng/mL）和中（其余全部）。UC术后恢复定义为没有任何保护装置。在考虑手术年龄、Charlson合并症指数和术前风险组后，通过单变量和多变量Cox回归分析评估神经保留状态与UC恢复之间的关系。结果平均随访42.2个月（1 ~ 78个月），993例（79.5%）患者UC痊愈。总体而言，1年和2年的UC恢复率分别为76%和79%。单变量Cox回归分析显示，手术年龄、术前风险组、医疗合并症和神经保留状态与UC恢复显著相关
ObjectiveTo demonstrate that nerve-sparing radical prostatectomy (NSRP) is associated with higher rates of urinary continence (UC) recovery compared with non-nerve-sparing procedures in patients with surgically treated organ-confined prostate cancer.Patients and MethodsThe study included 1249 patients treated with radical prostatectomy between 2003 and 2010. Patients were divided into three preoperative risk groups: low (PSA < 10 ng/mL, cT1, biopsy Gleason sum 20 ng/mL) and intermediate (all the remaining).Postoperative UC recovery was defined as the absence of any protection device.The association between nerve-sparing status and UC recovery was assessed in univariable and multivariable Cox regression analyses after accounting for age at surgery, Charlson Comorbidity Index and preoperative risk group.ResultsAt a mean follow-up of 42.2 months (range 1-78), 993 patients (79.5%) recovered UC. Overall, UC recovery rate at 1 and 2 years was 76% and 79%, respectively.On univariable Cox regression analysis, age at surgery, preoperative risk group, medical comorbidities and nerve-sparing status were significantly associated with UC recovery (all P