CAJ | 학술논문

目的探讨体质指数(body mass index,BMI)对腹腔镜下和开放式根治性前列腺切除术的影响. 方法回顾性分析2012年1月至2013年5月收治的226例行根治性前列腺切除术患者的临床资料.行腹腔镜手术患者106例,年龄(66.5±0.7)岁,身高(167.7±0.5)cm,体质量(66.8±0.9) kg,其中非肥胖组(BMI＜25 kg/m2)76例(71.7％),肥胖组(BMI≥25 kg/m2) 30例(28.3％);开放手术患者120例,年龄(65.8±0.7)岁,身高(168.1±0.5)cm,体质量(66.5±0.8)kg,其中非肥胖组84例(70.0％),肥胖组36例(30.0％).分别比较两种手术方式下非肥胖组与肥胖组的手术时间、术中出血量、手术前后血红蛋白(Hb)差值、术后Gleason评分、术后留置导尿时间等情况. 结果腹腔镜手术患者中非肥胖组和肥胖组的手术时间分别为(169.4±37.8) min和(188.5±42.3) min,手术前后血Hb差值分别为(-22.8±11.0)g/L和(-30.9±15.9)g/L,术中出血量分别为(115.9±68.9) ml和(178.3±126.4)ml,两组比较差异均有统计学意义(P＜0.05);术后留置导尿时间及术后Gleason评分比较差异无统计学意义(P＞0.05).开放手术患者中非肥胖组和肥胖组术中出血量分别为(413.7±289.4)ml和(594.4±534.9) ml,手术前后血Hb差值分别为(-27.2±13.3)g/L和(-34.9±15.8)g/L,两组间比较差异有统计学意义(P＜0.05);术后留置导尿时间、手术时间、术后Gleason评分等比较差异均无统计学意义(P＞0.05). 结论开放式根治性前列腺切除术的肥胖患者较非肥胖患者的术中失血更多.腹腔镜下根治性前列腺切除术的肥胖患者较非肥胖患者的术中失血更多,手术时间更长.
목적 탐토체질지수(body mass index,BMI)대복강경하화개방식근치성전렬선절제술적영향. 방법 회고성분석2012년1월지2013년5월수치적226례행근치성전렬선절제술환자적림상자료.행복강경수술환자106례,년령(66.5±0.7)세,신고(167.7±0.5)cm,체질량(66.8±0.9) kg,기중비비반조(BMI＜25 kg/m2)76례(71.7％),비반조(BMI≥25 kg/m2) 30례(28.3％);개방수술환자120례,년령(65.8±0.7)세,신고(168.1±0.5)cm,체질량(66.5±0.8)kg,기중비비반조84례(70.0％),비반조36례(30.0％).분별비교량충수술방식하비비반조여비반조적수술시간、술중출혈량、수술전후혈홍단백(Hb)차치、술후Gleason평분、술후류치도뇨시간등정황. 결과 복강경수술환자중비비반조화비반조적수술시간분별위(169.4±37.8) min화(188.5±42.3) min,수술전후혈Hb차치분별위(-22.8±11.0)g/L화(-30.9±15.9)g/L,술중출혈량분별위(115.9±68.9) ml화(178.3±126.4)ml,량조비교차이균유통계학의의(P＜0.05);술후류치도뇨시간급술후Gleason평분비교차이무통계학의의(P＞0.05).개방수술환자중비비반조화비반조술중출혈량분별위(413.7±289.4)ml화(594.4±534.9) ml,수술전후혈Hb차치분별위(-27.2±13.3)g/L화(-34.9±15.8)g/L,량조간비교차이유통계학의의(P＜0.05);술후류치도뇨시간、수술시간、술후Gleason평분등비교차이균무통계학의의(P＞0.05). 결론 개방식근치성전렬선절제술적비반환자교비비반환자적술중실혈경다.복강경하근치성전렬선절제술적비반환자교비비반환자적술중실혈경다,수술시간경장.
Objective To investigate the effect of body mass index (BMI) on laparoscopy and the open radical prostatectomy.Methods A retrospective analysis of 226 cases of radical prostatectomy from 2012 January to 2013 May was performed.106 patients underwent laparoscopic surgery,with aged 66.5±0.7,height (167.7±0.5) cm,weight (66.8±0.9) kg; 120 patients underwent open surgery,with aged (65.8±0.7) year,height (168.1±0.5) cm,weight (66.5±0.8) kg.Non-obese (BMI ＜25 kg/m2) and obese (BMI ≥ 25 kg/m2) were divided in each group.The preoperative serum PSA level,the operation time,the blood loss during operation,the preoperative and postoperative hemoglobin,Gleason score,and the postoperative indwelling catheter time were compared between non-obese group and obese group.In the laparoscopic surgery group including 76 non-obese cases (71.7％) and 30 obese cases (28.3％),no difference showed in PSA values and age before operation between the two sub-groups.In the open surgery group,including 84 non-obese cases (70.0％) and 36 obese cases (30.0％),no statistical difference of preoperative PSA values and age showed in the two sub-groups.Results In the laparoscopic group,the operation time is (nonobese 169.4±37.8 min and obese 188.5±42.3 min),and the blood Hb decrease(non-obese-22.8± 11.0g/L,obese-30.9±15.9 g/L) and the blood loss(non-obese 115.9±68.9 ml,obese 178.3±126.4 ml)showed significant difference in the two sub-groups (P＜0.05).The two sub-groups showed no statisticaldifference in postoperative indwelling catheter time and Gleason score (P＞0.05).In the open surgery group,the intraoperative hemorrhage (non-obese 413.7±289.4 ml,obese 594.4-±534.9 ml) and the hemoglobin decrease (non-obese-27.2± 13.3 g/L,obese-34.9± 15.8 g/L) showed significant difference (P＜0.05).The two sub-groups showed no significant difference in the preoperative hemoglobin,postoperative indwelling catheter time,Gleason score and operation time (P＞0.05).Conclusions For the patients who underwent prostatectomy,no matter by laparoscopic or open surgery,the blood loss was greater in obese subgroup than non-obese subgroup,and the operation time was much longer in obese group than non-obese group.