Objective: To investigate the effect of the distance between tumor and surgical margin on biochemical recurrence in patients with organ-confined prostate cancer.
Material and Method:The data of 208 patients, who underwent radical prostatectomy between 2012-2018, were retrospectively analyzed. The surgical margin status of 147 pathologically organ-confined patients was categorized as positive, close (<1mm) and negative. Surgical margin status and parameters affecting biochemical recurrence were examined. Furthermore, multivariate analysis was done to determine the parameters associated with biochemical recurrence.Results: Biochemical recurrence was detected in 21 (14.2%) of 147 patients. 38 (27.9%) men had negative surgical margins, 68 (46.2%) had close surgical margins and 41 (25.9%) had positive surgical margins. Tumor volume and ISUP grade were found to be statistically significant for positive surgical margin and close surgical margin patients compared to negative surgical margin patients. Close surgical margin was not statistically associated with biochemical recurrence. Preoperative high PSA (p<0.001) and positive surgical margin (p=0.021) were independent risk factors for biochemical recurrence.
Conclusion:According to our results, it is not necessary to include the presence of a close surgical margin in the pathology reports in patients with pathological organ-confined tumors and negative surgical margins.
Introduction
Diabetes mellitus (DM) is known as a risk factor of stress urinary incontinence after Holmium laser enucleation of the prostate (HoLEP). We aimed to compare the postoperative continence status of patients with and without DM, after HoLEP surgery.
Material and methods
A total of 214 patients who underwent HoLEP between January 2017 and January 2020 were retrospectively assessed. Functional outcomes, perioperative total operation time (TOT)(min), enucleation time (ET)(min), enucleation efficiency (EE)(g/min), enucleated tissue weight (ETW)(g), morcellation efficiency (ME)(g/min), morcellation time (MT)(min), continence status, intraoperative and postoperative complications according to Clavien–Dindo classification were recorded.
Results
A total of 96 patients had DM additional to benign prostate hyperplasia (BPH) (Group 1), while 118 patients had only benign prostate hyperplasia without DM (Group 2). When comparing preoperative and postoperative functional outcomes, a statistically significant improvement was observed in both groups from baseline to the 1
st
and 6
th
month follow-up (p ≤0.001). There were no statistically significant differences between groups in postoperative stress urinary incontinence at postoperative months 1 and 6 (1.7% vs 2.1%, p = 1 and 0.8% vs 1%, p = 1; respectively). There was no significant difference between groups in intraoperative and postoperative complications (p >0.05).
Conclusions
HoLEP is safe to perform in patients with DM at low complication and urinary incontinence rates.
BACKGROUND: Among the indicators of SIR are changes in the neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR). This study aimed to determine the effect of general and regional anesthesia on SIR during short-term transurethral bladder resection (TUR-B) surgery. METHODS: The 66 included patients were divided into 2 groups: Group 1 (general anesthesia) and Group 2 (regional anesthesia). The lymphocyte, platelet, and neutrophil counts before surgery and 1 h after surgery were obtained from the patients’ records. The indicators of SIR the NLR and PLR were calculated preoperatively and postoperatively. Differences between the groups in the NLR and PLR were investigated.RESULTS: At 1 h postsurgery there weren’t any significant differences in the neutrophil, lymphocyte, platelet counts, or the NLR and PLR in groups, as compared to presurgery; however, the lymphocyte count was higher (but not significantly) in both groups, as compared to presurgery. The neutrophil count and NLR were lower (but not significantly) in Group 1 at postsurgery. CONCLUSIONS: General and regional anesthesia have no effect on postoperative SIR in patients with bladder tumors that may require multiple surgeries and administration of anesthesia; however, we think larger scale prospective studies are needed to more clearly understand neutrophil count and NLR changes in bladder cancer surgery patients administered general anesthesia.
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