Pelvimetrik Ölçümlerin Açık Retropubik Radikal Prostatektomi Operasyon Süresi Üzerine Etkileri

Yıl 2023, Cilt: 15 Sayı: 2, 69 - 74, 31.05.2023

Mustafa Aydın , Lokman İrkilata , Mustafa Koray Kırdağ , Uğur Öztürk , Mehmet Özen , Emrah Küçük , Hakan Yıldız , Reha Ordulu , Mustafa Kemal Atilla

Öz

Amaç: Pelvimetrik ölçümlerin, prostat kanseri sebebiyle açık radikal retropubik prostatektomi olan hastalarda
operasyon süreleri üzerine etkisini araştırmak.

Gereç ve Yöntemler: 2014-2022 yılları arasında açık radikal retropubikprostatektomi yapılan ve radyolojik görüntülerine
ulaşılan 60 hasta çalışmaya dahil edildi. Hastaların demografik özellikleri, patoloji raporları ve ameliyat
notları kaydedildi. Hastaların operasyon öncesi çekilen düz grafileri, pelvik manyetik rezonans ve bilgisayarlı
tomografi görüntüleri incelendi. Anterior-superioriliak çıkıntılar arası uzunlık (ASİÇU), transvers pelvik girim çapı
(TPGÇ), intertuberoz uzunluk (İTU), anteroposterior pelvik girim çapı (APGÇ), pubik yükseklik (PY), superior pubis-
mid-tuberoz nokta uzunluğu (SPMNU) ve infrapubik açı (İA) ölçümleri yapıldı. Ölçümlerin operasyon süresi
üzerine etkileri değerlendirildi.

Bulgular: Hastaların ortalama yaşları 63,21±15,12, ortalama vücut kitle indeksleri 25,95±5,45 olarak bulundu.
Hastaların ortalama prostat volümleri 52,15±21,2 mL, prostat spesifik antijenleri (PSA) 20,48±5,34 ng/ml ve operasyon
süreleri 137,36±30,2 dakika olarak ölçüldü, 24 (%40) hastanın Gleason skoru 7 ve üzerinde idi, 20 (%33)
hastada parmakla rektal muayene bulgusu vardı ve hastaların 18’i (%30) pT3 evredeydi. Pelvimetrik ölçümlerin
operasyon süresi üzerine etkisi incelendiğinde ise ölçümlerle operasyon süresi arasında bir korelasyon saptanmamıştır.

Sonuç: Hastaların anatomik özellikleri açık radikal retropubik prostatektomi operasyonu üzerine etkili olabilir
fakat çalışmamız sonucunda pelvimetrik ölçümlerin operasyon süresi üzerine bir etkisi saptanmamıştır.

Anahtar Kelimeler

prostat kanseri, radikal prostatektomi, pelvimetrik ölçümler

The Effects of Pelvimetric Measurements on the Operation Time of Open Retropubic Radical Prostatectomy

Öz

Objective: To investigate the effect of pelvimetric measurements on the operative time of patients who
underwent open radical retropubic prostatectomy for prostate cancer.

Material and Methods: Sixty patients who underwent open radical retropubic prostatectomy between
2014 and 2022 and who seradiological images were accessed were included in the study. Demographic
characteristics, pathology reports and surgery notes of the patients were recorded. Preoperative X-rays,
pelvic magnetic resonance and computed tomography images of the patients were examined. Inter-antero
superior iliac spine distance (IASISD), Transverse pelvic brim distance (TPBD), Inter tuberous distance
(ITD), Anteroposterior pelvic brim distance (APBD), Pubic height (PH), Superior pubis to mid-tuberous point
(SPMP) and Infrapubic angle (IA) measurements were made.The effects of the measurements on the operation
time were evaluated.

Results: The mean age of the patients was 63.21±15.12, and the mean body massindex was 25.95±5.45.The
mean prostate volume of the patients was 52.15±21.2 mL, prostate specific antigen (PSA) was 20.48±5.34
ng/ml, and the operation time was 137.36±30.2 minutes. 24 (40%) patients had a Gleasonscore of 7 and
above, 20 (33%) patients had digital rectal examination findings and 18 (30%) patients were in pT3 stage.
When the effect of pelvimetric measurements on the operation time was examined, no correlation wasfound
between the measurements and the operation time.

Conclusion: The anatomical features of the patients may have an effect on the open radical retropubic
prostatectomy operation, but as a result of our study, we did not find any effect of pelvimetric measurements
on the operation time.

Anahtar Kelimeler

prostate cancer, radical prostatectomy, pelvimetric measurements

Kaynakça

• 1. Pattinson RC, Cuthbert A, Vannevel V. Pelvimetryfor fetal cephalicpresentations at orneartermfordeciding on mode of delivery. Cochrane Database SystRev. 2017 Mar 30;3(3):CD000161. https://doi.org/10.1002/14651858.CD000161 2. El-Hamamy E, Arulkumaran S. Poorprogress of labour. CurrentObstetrics&Gynaecology. 2005;15(1):1–8. https://doi.org/10.1016/j.curobgyn.2004.09.001
• 3. Neill MG, Lockwood GA, McCluskey SA, Fleshner NE. Preoperativeevaluation of the "hostile pelvis" in radicalprostatectomywithcomputedtomographicpelvimetry. BJU Int. 2007 Mar;99(3):534-8. https://doi.org/10.1111/j.1464-410X.2006.06640.x
• 4. Caldwell WE, Moloy HC. AnatomicalVariations in TheFemale Pelvis andTheirEffect in LaborWith a SuggestedClasification. Am J ObstetGynecol 1933; 26:479. https://doi.org/10.1016/S0002-9378(33)90194-5
• 5. Pystynen P, Ylöstalo P, Järvinen PA. Pelvimetryby ultrasound in latepregnancy. Ann ChirGynaecolFenn. 1967;56(2):118-21. PMID: 6065320.
• 6. Federle MP, Cohen HA, Rosenwein MF, Brant-Zawadzki MN, Cann CE. Pelvimetrybydigitalradiography: a low-doseexamination. Radiology. 1982 Jun;143(3):733-5. https://doi.org/10.1148/radiology.143.3.7079500
• 7. Stark DD, McCarthy SM, Filly RA, Parer JT, Hricak H, Callen PW. Pelvimetrybymagneticresonanceimaging. AJR Am J Roentgenol. 1985 May;144(5):947-50. https://doi.org/10.2214/ajr.144.5.947
• 8. Wagner B, Gnann R, Hautmann R, De Petriconi R. Predictivefactorsfortechnicaldifficultiesduringretropubicradicalprostatectomyusingexternalpelvimetry. ProgUrol. 2002 Apr;12(2):348-50. French. PMID: 12108360.
• 9. Sekita N, Egoshi K, Mikami K. Predictingbloodlossduringradicalprostatectomyusinginternalpelvimetry. HinyokikaKiyo. 2007 Jan;53(1):19-23. Japanese. PMID: 17310764.
• 10. Turner W. The Index of thePelvicBrim as a Basis of Classification. J AnatPhysiol. 1885 Oct;20(Pt 1):125-43. PMID: 17231606; PMCID: PMC1288541.
• 11. vonBodman C, Matikainen MP, Yunis LH et al. Ethnicvariation in pelvimetricmeasuresanditsimpact on positivesurgicalmargins at radicalprostatectomy. Urology. 2010 Nov;76(5):1092-6. https://doi.org/10.1016/j.urology.2010.02.020
• 12. Matikainen MP, vonBodman CJ, Secin FP et al. Thedepth of theprostaticapex is an independentpredictor of positiveapicalmargins at radicalprostatectomy. BJU Int. 2010 Sep;106(5):622-6. https://doi.org/10.1111/j.1464-410X.2009.09184.x
• 13. Ongun S, Demir O, Gezer NS, Gurboga O, Bozkurt O, Secil M. Impact of pelvicbiometricmeasurements, visceralandsubcutaneousadiposetissueareas on trifectaoutcomeandsurgicalmarginstatusafteropenradicalretropubicprostatectomy. Scand J Urol. 2015 Apr;49(2):108-14. https://doi.org/10.3109/21681805.2014.967812. Epub 2014 Oct 16.
• 14. vonBodman C, Matikainen MP, Favaretto RL et al. Pelvimetricdimensions do not impactuponnervesparingorerectilefunctionrecovery in patientsundergoingradicalretropubicprostatectomy. J SexMed. 2011 Feb;8(2):567-74. https://doi.org/10.1111/j.1743-6109.2010.01911.x.