Application of cognitive fusion combined with 12-core systematic transperineal prostate biopsy in daytime operation mode
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摘要: 目的 探讨认知融合联合12针系统经会阴前列腺穿刺活检在日间手术模式下开展的安全性和有效性。方法 回顾性收集2019年6月—2022年8月于青岛大学附属烟台毓璜顶医院在日间手术模式下行经会阴前列腺认知融合穿刺活检的489例患者的临床病理特征，观察前列腺癌(prostate cancer，PCa)检出率、手术时间、疼痛耐受度、并发症等情况。结果 共检出PCa 261(53.37%)例，有临床意义前列腺癌(clinically significant prostate cancer，csPCa)占78.93%(206/261)。系统穿刺与认知融合穿刺的PCa总检出率差异无统计学意义(47.03% vs 44.17%，230例vs 216例，P=0.135)，认知融合穿刺较系统穿刺检出更多csPCa(36.61% vs 32.92%，179例vs 161例，P < 0.001)。平均手术时间(8.92±0.98) min；视觉模拟评分(visual analogue scale，VAS)平均(2.50±1.16)分；术后并发症发生率为10.02 %，其中急性尿潴留5例，血尿35例，发热9例，无脓毒症发生，经对症处理后均好转。结论 认知融合联合12针系统经会阴前列腺穿刺活检在日间手术模式下开展是安全有效的。Abstract: Objective To evaluate the safety and efficacy of cognitive fusion combined with 12-core systematic transperineal prostate biopsy in daytime operation mode.Methods The clinical data of 489 patients who underwent transperineal cognitive fusion prostate biopsy in daytime operation mode in Yantai Yuhuangding Hospital were analyzed retrospectively from June 2019 to August 2022.Prostate cancer detection rate, operation time, hospital stay, visual analogue scale, and complications were recorded.Results Prostate cancer was detected in 261(53.37%) patients and cancer detection rates for clinically significant prostate cancer was 78.93%(206/261). There was no significant difference in the total PCa detection rate between systemic and cognitive fusion biopsy (47.03% vs 44.17%, 230 cases vs 216 cases, P=0.135), and more clinically significant prostate cancers were detected by cognitive fusion biopsy (36.61% vs 32.92%, 179 cases vs 161 cases, P < 0.001). The average operation time was (8.92±0.98) minutes. The average visual analogue scale was 2.50±1.16(0-6). Complication incidence was 10.02%, including urinary retention (5 patients), hematuria (35 patients) and fever (9 patients). No patients had sepsis and all complications were improved after treatment.Conclusion Cognitive fusion combined with 12-core systematic transperineal prostate biopsy in daytime operation mode was safe and effective.
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Key words:
- transperineal /
- prostate biopsy /
- daytime operation /
- cognitive fusion
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表 1 入组患者的一般资料
例，X±S 指标 入组患者 PCa 例数 489 261 年龄/岁 65.37±9.20 64.90±9.46 PSA/(ng/mL) 12.39±6.20 12.45±6.33 PI-RADS评分/分 3 243 91 4 152 102 5 94 68 Gleason评分/分 6 55 7(3+4) 73 7(4+3) 57 ≥8 76 csPCa 206 206 
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表 2 穿刺病理学结果
认知融合穿刺 系统穿刺 总数 csPCa cisPCa 非PCa csPCa 134 31 14 179 cisPCa 3 17 17 37 非PCa 24 21 228 273 总数 161 69 259 489 注：cisPCa临床非显著性前列腺癌。
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表 3 穿刺结果比较
例 指标 系统穿刺 认知融合穿刺 联合穿刺 PCa检出率/% 47.03
(230/489)44.17
(216/489)53.37
(261/489)csPCa检出率/% 32.92
(161/489)36.61
(179/489)42.13
(206/489)Gleason评分/分 6 69 37 55 7(3+4) 71 86 73 7(4+3) 44 50 57 ≥8 46 43 76
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