Comparative analysis of perioperative clinical data and the dynamics of peripheral hemogram changes in patients with localized prostate cancer who have undergone retropubic and endoscopic radical prostatectomy
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Abstract
The objective: to analyze the clinical data and postoperative blood loss and peripheral hemogram changes in patients who were undergone retropubic radical prostatectomy (RRPE) and endoscopic (minimally invasive) radical prostatectomy (ERPE), and hold them intergroup comparison.
Patients and methods. There were estimated results of treatment of localized prostate cancer (PC) in 219 patients who were undergone radical prostatectomy (RPE) at the clinic SI «Institute of Urology of NAMS Ukraine» for 2013–2015 years. The patients were divided into two groups. Group I included 164 (74,9%) patients (were undergone EREP). Group II included 55 (25,1%) patients (were undergone RRPE). The clinical, laboratory, computational and pathomorphological data for each patient were analyzed. The data were processed using parametric and nonparametric statistics (Student’s t-test, Mann-Whitney test, chi-squared test et al.).
Results. The mean age of patients in group І was 64,8±6,9 years, in group II – 62,7±4,5 years, there were marked statistically significant increasing in age of patients in group І (p=0,0115). A decreasing in the volume of intraoperative blood loss were detected in group I with respect to group II, respectively, 400 [200; 600] ml vs 500 [300; 800] ml (p=0,0439). The frequency of blood transfusions was 12,8% vs 12,7% in groups I and II, respectively (p=0,9881). The time of bladder catheterization of group I was statistically significantly lower than that of group II (p=0,0012), the median was 12 [9; 15] vs 14 [12; 16] days, respectively. The median of the preoperative PSA in group I was 10,8 [7,8; 15,8] ng/ml, and in group II – 12,5 [9,2; 22,3] ng/ml (p=0,0485). ДHb in the operated patients was in the group I -23 [-33; -13] g/L vs -37 [-45; -27] g/L in group II (p<0,0001). Leukocyte index of value of leukocytes and ESR (ILESR) before holding RPE statistically significant in the study groups did not differ (p=0,7779), after RPE in ERPE group it was 1,9 [1,2; 2,8] vs 2,4 [1,5; 3,3] in RRPE group (p=0,0268).
Conclusions. The data, which were got about reducing of time bladder catheterization, ΔHb ILESR after RPE in patients with localized prostate cancer, who were operated in the volume of ERPE, has indicated lower general alert potential, and therefore endoscopic surgery techniques was better tolerated in relation to RRPE and it have laid down the basis for further study of the problem of the violation of systemic homeostasis during and after the RPE.
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