目的:前列腺癌根治术后复发疝的发生率较高,因此本文探讨前列腺癌根治术后腹股沟疝的发生率及危险因素。
方法:回顾性分析湖州市第一人民医院2019年3月至2021年5月251例前列腺癌根治术患者的临床资料。根据腹股沟疝的发生,将受试者分为研究组和对照组,并对各组临床资料进行统计学分析,采用多因素Logistic分析寻找预测腹股沟疝发生的独立影响因素。根据腹股沟疝的发生和时间绘制Kaplan-Meier生存曲线。
结果:前列腺癌手术后腹股沟疝的总发病率为14.7%(37/251),平均时间为8.58±4.12个月。淋巴结清扫术患者腹股沟疝的平均时间为7.61±4.05(月),未进行淋巴结清扫的患者为9.16±4.15(月),两者比较差异无统计学意义(P>0.05)。腹股沟疝的发病率随年龄的变化无统计学意义,BMI,高血压,糖尿病,PSA,既往腹部手术及手术入路(P>0.05),手术方式和盆腔淋巴结清扫方式差异有统计学意义(P<0.05)。腹股沟疝组盆腔淋巴结清扫的发生率为24.3%(14/57),显著高于对照组11.8%(23/194)。Logistic回归分析显示盆腔淋巴结清扫是前列腺癌术后腹股沟疝的危险因素(OR=0.413,95%Cl:0.196~0.869,P=0.02)。Kaplan-Meier生存曲线显示,盆腔淋巴结清扫组腹股沟疝发生率明显高于对照组(P<0.05)。
结论:盆腔淋巴结清扫是前列腺癌根治术后腹股沟疝的危险因素。
OBJECTIVE: The incidence of recurrent hernia after radical resection of prostate cancer is high, so this article discusses the incidence and risk factors of inguinal hernia after radical resection of prostate cancer.
METHODS: This case control study was conducted in The First People\'s Hospital of Huzhou clinical data of 251 cases underwent radical resection of prostate cancer in this hospital from March 2019 to May 2021 were retrospectively analyzed. According to the occurrence of inguinal hernia, the subjects were divided into study group and control group, and the clinical data of each group were statistically analyzed, Multivariate Logistic analysis was performed to find independent influencing factors for predicting the occurrence of inguinal hernia. The Kaplan-Meier survival curve was drawn according to the occurrence and time of inguinal hernia.
RESULTS: The overall incidence of inguinal hernia after prostate cancer surgery was 14.7% (37/251), and the mean time was 8.58 ± 4.12 months. The average time of inguinal hernia in patients who received lymph node dissection was 7.61 ± 4.05 (month), and that in patients who did not receive lymph node dissection was 9.16 ± 4.15 (month), and there was no significant difference between them (P > 0.05). There were no statistically significant differences in the incidence of inguinal hernia with age, BMI, hypertension, diabetes, PSA, previous abdominal operations and operative approach (P > 0.05), but there were statistically significant differences with surgical method and pelvic lymph node dissection (P < 0.05). The incidence of pelvic lymph node dissection in the inguinal hernia group was 24.3% (14/57), which was significantly higher than that in the control group 11.8% (23/194). Logistic regression analysis showed that pelvic lymph node dissection was a risk factor for inguinal hernia after prostate cancer surgery (OR = 0.413, 95%Cl: 0.196-0.869, P = 0.02). Kaplan-Meier survival curve showed that the rate of inguinal hernia in the group receiving pelvic lymph node dissection was significantly higher than that in the control group (P < 0.05).
CONCLUSIONS: Pelvic lymph node dissection is a risk factor for inguinal hernia after radical resection of prostate cancer.