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Robot-Assisted Radical Antegrade Modular Pancreatosplenectomy Including Resection and Reconstruction of the Spleno-Mesenteric Junction
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Predicting factor analysis of postoperative complications after robot-assisted radical cystectomy: Multicenter KORARC
Hwanik Kim1, Byong Chang Jeong2, Sangchul Lee1
1Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
Summary
Robot-assisted radical cystectomy for bladder cancer can lead to complications, with diabetes, kidney disease, and dyslipidemia being key predictors. Higher intraoperative fluid volume also increases complication risk, potentially impacting cancer survival rates.
Area of Science:
- Urology
- Oncology
- Surgical Innovation
Background:
- Robot-assisted radical cystectomy (RARC) is a minimally invasive surgical approach for bladder cancer.
- Understanding postoperative complications is crucial for optimizing patient outcomes.
- Predictors for complications after RARC require further investigation.
Purpose of the Study:
- To evaluate the incidence of postoperative complications following RARC in bladder cancer patients.
- To identify predictors associated with postoperative complications after RARC.
Main Methods:
- A prospective review of 730 RARC patient records from 13 tertiary centers (2007-2019).
- Comparison of perioperative outcomes between patients with and without complications.
- Regression analyses to identify factors associated with any and high-grade complications.
Main Results:
- Overall complication rate was 57.8%, with high-grade (Clavien-Dindo ≥3) complications at 21.1%.
- Complication group associated with diabetes mellitus, chronic kidney disease, dyslipidemia, longer operation time, and increased blood loss/fluid volume.
- Dyslipidemia and intraoperative fluid volume predicted high-grade complications.
- Diabetes, CKD, dyslipidemia, and fluid volume predicted any complication.
Conclusions:
- Diabetes mellitus, chronic kidney disease, dyslipidemia, and high intraoperative fluid volume are significant predictors of postoperative complications after RARC.
- Patients experiencing complications may have a reduced cancer-specific survival rate.
