Exploration of the efficacy and safety of transperineal prostate biopsy in laparoscopic prostatectomy for prostate cancer
Pan Runyang
Su Wenxing
Lin Rongkai
Abstract：Objective:To investigate the efficacy and safety of transperineal prostate biopsy(TPPB)in laparo-scopic prostatectomy for prostate cancer.Methods:A retrospective study was conducted on 106 prostate cancer pa-tients admitted to the No 910 Hospital Affiliated to Joint Logistic Support Force of PLA from March 2020 to August 2022 were divided into transperineal group and transrectal group according to different surgical protocols,with 53 cas-es in each group.Both groups underwent laparoscopic prostatectomy,with the transperineal group undergoing TPPB and the transrectal group undergoing transrectal prostate biopsy(TRPB).The complete resection rate of the lesion,surgical indicators,perioperative trauma stress hormones[adrenocorticotropic hormone(ACTH),cortisol(Cor),al-dosterone(ALD)],prostate specific antigen(PSA),postoperative pathological Gleason score,pre-and post-opera-tive quality of life[prostate cancer symptom score scale(EPCI)],and complications were compared between the two groups.Statistical methods used were t-test,χ2 test,and Ridit test.Results:There were no significant differenc-es in the complete resection rate of the lesion,time to separate the apex of the prostate,length of hospital stay,posi-tive rate of incisal margin,and incidence of postoperative complications between the two groups(P values were 1.000,0.597,0.182,0.713,and 0.540,respectively).The postoperative serum PSA levels in both groups de-creased compared with those before surgery(P<0.001),but there was no significant difference between the groups(P>0.05).Compared with the transrectal group,the transperineal group had shorter operation time and time to sepa-rate the anterior rectal space,less intraoperative blood loss(t values were 14.034,24.953,and 11.605,respectively,all P<0.001),lower rate of severe adhesion during surgery(χ2=8.774,P=0.003),and better postoperative patho-logical Gleason score(U=2.489,P=0.013),all with statistically significant differences.The levels of serum ACTH,Cor,and ALD in both groups increased significantly at 12,24,and 48 hours after surgery(all P<0.001),and were lower in the transperineal group than in the transrectal group(all P<0.001).At 3 months after surgery,the scores of urinary function,intestinal function,hormonal function,and sexual function in the EPCI scale increased sig-nificantly in both groups compared with those before surgery(all P<0.001),and were higher in the transperineal group than in the transrectal group(all P<0.001).Conclusion:Laparoscopic surgery for prostate cancer after TPPB can shorten the operation time,reduce intraoperative blood loss and severe adhesions,reduce the degree of trauma,and have a lower risk of pathological progression,higher quality of life,and no increased complications.
Keywords：prostate cancerlaparoscopic surgerytransperineal prostate biopsysecurityrisk of pathological pro-gressionquality of life
Publication Date：2024-06-05
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 176-182 )