Effect of prostate volume on efficacy and postoperative pathology of robot-assisted laparoscopic radical prostatectomy

doi:10.3877/cma.j.issn.1674-3253.2025.03.015

Abstract

Abstract:

Objective

To investigate the effect of prostate volume on efficacy and postoperative pathology of robot-assisted laparoscopic radical prostatectomy （RALRP）.

Methods

Data were collected from 44 patients who were diagnosed with prostate cancer and underwent RALRP in the Third Affiliated Hospital of Sun Yat-sen University from January 2022 to March 2024.Patients were divided into small prostate group （＜50 mL） and large prostate group （≥50 mL） according to the volume of the prostate gland，and were compared to the two groups in terms of operative time， intraoperative bleeding， postoperative Hb changes， hospitalization days， biopsy and postoperative Gleason score and variation tendency， surgical margins status， immediate postoperative urinary continence and other clinical parameters.

Results

The differences between the two groups in terms of operation time， peroperative bleeding， postoperative Hb changes，hospitalization days， and immediate postoperative urinary continence rate were not statistically significant（P＞0.05）， the positive rate of surgical margin and the upgraded rate of postoperative Gleason score in the small volume prostate group was higher than those in the large volume prostate group （P＜0.05）.

Conclusion

Small prostate is associated with poor pathology after RALRP and should be emphasized in clinical work.

Key words: Prostate tumor, Robot, laparoscopy, prostatectomy, Positive surgical margin, Continence, Pathology

Xueqing Li, Chi Zhang, Xiaopeng Liu. Effect of prostate volume on efficacy and postoperative pathology of robot-assisted laparoscopic radical prostatectomy[J]. Chinese Journal of Endourology(Electronic Edition), 2025, 19(03): 372-376.

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https://zhqjmnmwkzz.cma-cmc.com.cn/EN/Y2025/V19/I03/372

Figures/Tables 2

项目	＜50 mL组（n=25）	≥50 mL组（n=19）	统计值	P值
前列腺体积［mL，（ $\overset{ˉ}{x}$ ± s ）］	29±10	86±29	t=-0.812	＜0.001
年龄［岁，（ $\overset{ˉ}{x}$ ± s ）］	72±8	70±9	t=0.671	0.506
PSA［ng/ml，M（Q）］	10.8（19.9）	10.7（20.4）	Z=-0.083	0.934
PSAD［ng/ml²，M（Q）］	0.33（0.55）	0.16（0.18）	Z=2.405	0.016
Hb［g/L，（ $\overset{ˉ}{x}$ ± s ）］	130±16	128±190	t=0.375	0.709
穿刺Gleason评分［例（%）］			χ ²=0.247	0.884
＜7	5（20.0）	5（26.3）
7	7（28.0）	5（26.3）
＞7	13（52.0）	9（47.4）
临床分期［例（%）］			χ ²=1.933	0.380
T₁	3（12.0）	5（26.3）
T₂	15（60.0）	11（57.9）
T₃	7（28.0）	3（15.8）

项目	＜50 mL组（n=25）	≥50 mL组（n=19）	统计值	P值
前列腺体积［mL，（ $\overset{ˉ}{x}$ ± s ）］	29±10	86±29	t=-0.812	＜0.001
年龄［岁，（ $\overset{ˉ}{x}$ ± s ）］	72±8	70±9	t=0.671	0.506
PSA［ng/ml，M（Q）］	10.8（19.9）	10.7（20.4）	Z=-0.083	0.934
PSAD［ng/ml²，M（Q）］	0.33（0.55）	0.16（0.18）	Z=2.405	0.016
Hb［g/L，（ $\overset{ˉ}{x}$ ± s ）］	130±16	128±190	t=0.375	0.709
穿刺Gleason评分［例（%）］			χ ²=0.247	0.884
＜7	5（20.0）	5（26.3）
7	7（28.0）	5（26.3）
＞7	13（52.0）	9（47.4）
临床分期［例（%）］			χ ²=1.933	0.380
T₁	3（12.0）	5（26.3）
T₂	15（60.0）	11（57.9）
T₃	7（28.0）	3（15.8）

项目	＜50 mL组（n=25）	≥50 mL组（n=19）	统计值	P值
手术时间［min，（ $\overset{ˉ}{x}$ ± s ）］	286±44	306±83	t=-1.033	0.308
术中出血量［mL，（ $\overset{ˉ}{x}$ ± s ）］	99±62	97±59	t=0.120	0.905
术后Hb变化［g/L，（ $\overset{ˉ}{x}$ ± s ）］	-20±12	-18±12	t=-0.475	0.638
住院天数［d，（ $\overset{ˉ}{x}$ ± s ）］	16±6	16±5	t=0.241	0.811
切缘阳性［例（%）］	13（52.0）	4（21.1）	χ ²=4.361	0.037
大体标本Gleason评分［例（%）］			χ ²=1.570	0.456
＜7	2（8.0）	4（21.1）
7	08（32.0）	5（26.3）
＞7	15（60.0）	10（52.6）
术后Gleason评分升级［例（%）］	10（40.0）	2（10.5）	χ ²=4.728	0.030
病理分期［例（%）］			χ ²=0.900	0.343
T₁	15（60.0）	14（73.7）
T₂	10（40.0）	5（26.3）
术后即刻尿控	18（72.0）	13（68.4）	χ ²=0.066	0.797

项目	＜50 mL组（n=25）	≥50 mL组（n=19）	统计值	P值
手术时间［min，（ $\overset{ˉ}{x}$ ± s ）］	286±44	306±83	t=-1.033	0.308
术中出血量［mL，（ $\overset{ˉ}{x}$ ± s ）］	99±62	97±59	t=0.120	0.905
术后Hb变化［g/L，（ $\overset{ˉ}{x}$ ± s ）］	-20±12	-18±12	t=-0.475	0.638
住院天数［d，（ $\overset{ˉ}{x}$ ± s ）］	16±6	16±5	t=0.241	0.811
切缘阳性［例（%）］	13（52.0）	4（21.1）	χ ²=4.361	0.037
大体标本Gleason评分［例（%）］			χ ²=1.570	0.456
＜7	2（8.0）	4（21.1）
7	08（32.0）	5（26.3）
＞7	15（60.0）	10（52.6）
术后Gleason评分升级［例（%）］	10（40.0）	2（10.5）	χ ²=4.728	0.030
病理分期［例（%）］			χ ²=0.900	0.343
T₁	15（60.0）	14（73.7）
T₂	10（40.0）	5（26.3）
术后即刻尿控	18（72.0）	13（68.4）	χ ²=0.066	0.797

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