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老年患者中局部质选择性手术的发病率:当代多中心研究
Leonardo D Borregales1, Alessio Pecoraro2, Eduard Roussel3
1Department of Urology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA.
概括
与年轻患者相比,接受局部质手术 (LRM) 的老年患者经历了类似的手术内和高度术后并发症. 然而,任何级别的并发症仍然是一个问题,需要多学科的策略,以实现最佳的患者选择和减少手术发病率.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 老年病的医生 老年病的医生
背景情况:
- 全球人口老龄化和细胞癌 (RCC) 发病率的增加.
- 超过25%的局部质 (LRM) 在70岁以上的患者中被诊断为局部质.
- 老年人LRM治疗中的临床困境是由于功能储备减少和死亡风险竞争.
研究的目的:
- 在老年患者中评估LRM选择性手术的当代发病率.
- 专注于手术内和术后的并发症.
- 比较不同年龄组的结果.
主要方法:
- 来自四个欧洲中心的前性维护数据库的回顾性分析 (1/2015-12/2021).
- 纳入标准:eGFR ≥60,正常的逆侧脏,单个cT1-T2N0M0LRM,部分或彻底的腎切除术.
- 年龄组: <50 (年轻人), 50-75 (中年人), >75 (老年人). 根据克拉维恩-丁多 (CD) 分类的并发症.
主要成果:
- 包括2469名患者;17.2%是老年人.
- 与年轻人群相比,老年患者的并发症指数较高,但手术后并发症 (IOC) 和任何级别的术后并发症 (AGC) 的发生率相似.
- 在不同年龄组中,高度术后并发症 (HGC) 没有显著差异. 开放方法和部分切除术 (PN) 预测了AGC;开放方法预测了HGC.
结论:
- 在第三级转诊中心对LRM的选择性手术具有较低的IOC和HGC风险,即使在老年患者中也是如此.
- 存在不可忽视的AGC风险,特别是在老年人中.
- 需要多学科的策略来选择老年LRM患者进行手术,并尽量减少发病率.
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