The Correlation Analysis Of Positive Surgical Margin After Extraperitoneal Laparoscopic Radical Prostatectomy

Objective : To explore the relative risk factors of positive surgical margin in extraperitoneal laparoscopic radical prostatectomy.Methods:Retrospective analysis of 99 cases of extraperitoneal laparoscopic radical prostatectomy in our hospital from January2010 to December 2018.The age ranged from 51 to 79 years,with an average of(65.37±6.07)years;PSA 2.8 to 79.5ng/mL,with an average of(16.84±12.28)ng/mL.The characteristics of postoperative pathological margins were analyzed.According to age,body mass index,preoperative PSA,positive percentage of puncture needle,puncture to operation time,biopsy Gleason score,clinical T stage,prostate cancer risk score,postoperative pathological Gleason score,postoperative T stage,abdominal pelvic surgery was grouped.Chi-square test was used for single factor analysis and binary logistic regression analysis for multivariate to evaluate the correlation between clinical and pathological data and positive surgical margins.Results:99 patients were successfully completed under laparoscopy,and no cases were converted to open.The average operation time was(199.66±66.01)minutes,and the intraoperative blood loss was(152.02±140.28)ml.Postoperative pathology confirmed prostate cancer,and 26 cases(26.3%)were positive surgical margin.Univariate risk factor analysis was performed which showed that positive needle percentage(P=0.047),biopsy Gleason score(P=0.023),postoperative pathological Gleason score(P=0.007),and postoperative T Stage(P=0.004)had significant correlation with positive surgical margin.The age(P=0.134),body mass index(P=0.838),PSA(P=0.299),puncture to surgery time(P=1.000),clinical T stage(P=0.821),prostate cancer risk score(P=0.903)and history of abdominal pelvic surgery(P=0.607)had no significant correlation.The multivariate analysis showed that only postoperative T stage(P=0.011)was an independent risk factor for positive surgical margin.Conclusions:The positive needle percentage,biopsy Gleason score,postoperative pathological Gleason score and the postoperative T stage had significant correlation with positive surgical margin.The higher the percentage of positive biopsy needles,the biopsy Gleason score and the postoperative T stage,the higher the positive surgical margin.Postoperative T stage was an independent risk factor for positive surgical margins after extraperitoneal laparoscopic radical prostatectomy.