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首页> 外文期刊>Journal of robotic surgery >A prediction model relating the extent of intraoperative fascia preservation to erectile dysfunction after nerve-sparing robot-assisted radical prostatectomy
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A prediction model relating the extent of intraoperative fascia preservation to erectile dysfunction after nerve-sparing robot-assisted radical prostatectomy

机译：一种预测模型，将术中筋膜术后术治疗术后术后功能障碍术治疗术后辅助自由基前列腺切除术

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Robot-assisted radical prostatectomy (RARP) is performed in patients with prostate cancer. Unfortunately, 10-46% of patients may still suffer from limited erectile function (EF) after RARP. This study aimed to develop a prediction model based on the extent of fascia preservation (FP) and postoperative EF after RARP. A previously developed FP score quantizing the extent and regions of nerve-preservation was determined in a cohort of 1241 patients who underwent RARP. The predictive value of the FP score for post-prostatectomy EF (following the international index erectile function (IIEF) score, EF domain) was analyzed. To increase the predictive value of the scoring system, the FP regions were related to postoperative EF, nerve distribution and co-morbidity factors. Finally, a prediction model for EF was developed based on the studied cohort. When corrected for the preoperative IIEF-EF, the FP score was shown to be a significant denominator for IIEF (p = 2.5 X 10~-15) with an R~2 of 35%. Variable selection performed using the Akaike information criterion led to a final prediction model for postoperative IIEF after nerve-preservation based on the FP score. Furthermore, patient's age, preoperative IIEF score, CCIS and use of clips for nerve sparing were significantly associated with postoperative IIEF-EF. More anterior fascia preservation was correlated with better EF outcome and age was a strong independent predictor of EF outcome. In older men, the relative benefit of more extensive fascia preservation was at least similar to younger men, despite a lower baseline IIEF-EF score. Quantitative nerve-sparing FP scoring could be related to the postoperative IIEF-EF and integrated into a multivariate prediction model, which includes with age, use of surgical clips, the Charlson Comorbidity Index Score (CCIS), and preoperative IIEF-EF. When further validated the prediction model could provide patients and care-givers a qualitative estimation of EF outcome after RARP.
机译：机器人辅助自由基前列腺切除术（RARP）是在前列腺癌患者中进行的。不幸的是，10-46％的患者仍可能在RARP之后患有有限的勃起功能（EF）。本研究旨在基于筋膜保护（FP）和术后EF后的预测模型。先前开发的FP评分量化了神经保存的程度和区域是在接受RARP的1241名患者的队列中确定的。分析了前列腺切除术的FP得分的预测值（在国际指数勃起函数（IIEF）评分之后，EF域名之后）。为了增加评分系统的预测值，FP区域与术后EF，神经分布和共发病率因子有关。最后，基于研究的队列开发了EF的预测模型。当校正术前IIEAIE-EIEIAIE-EIEF-EIEIAIE-EIEAV时，FP得分被证明是IIEAII（P = 2.5×10〜15）的重要分母，其R〜2为35％。使用Akaike信息标准执行的可变选择导致了基于FP得分的神经保存后的术后Iief的最终预测模型。此外，患者的年龄，术前IIET评分，CCI和用于神经备件的夹子与术后IIEIE-EIEV-EIEV-EIEC备受显着相关。更多的前筋膜保存与更好的EF结果和年龄相关，年龄是EF结果的强烈独立预测因子。在老年人中，尽管基线IIET-EIEV-EIEV-EIEV-EIEV-EIEV-EIEV-EIEV-EIEV-EIEV-EIEVE-EIEV-EIEVE-EIEV-EIEV-EIEVE-EIEV-EIEF-EIEV-EIF-EIEF-EIEV-EIEF-EIEV-EIED-EIEVE-EIF-EIF-EIEVE-EIEV-EIF-EIEVE-EIF-EIF-EIF-EIEF-EIEVES-EIF-EIF-EIEVE-EIF-EIET-EIF-EIF-EIEVE-EIEVE-EIF-EIF-EIEVE-EIF-EIF-EIEVES，但更广泛的筋膜保存的相对益处至少是相似的。定量神经保留FP得分可能与术后IIEF-EF并融入了多变量预测模型，它随着年龄的增长包括，利用手术夹子，在查尔森合并症指数评分（CCIS），与术前IIEF-EF。进一步验证后，预测模型可以提供患者和护理者在RARP后对EF结果进行定性估算。

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