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术后并发症和选择非体内尿路转移的决定因素在接受机器人辅助激进囊切除术的患者中:初步经验

Takahiro Inoue¹, Manabu Kato¹, Takeshi Sasaki¹

¹Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Mie, Japan.

Translational cancer research

|February 27, 2024

概括

机器人辅助激进囊切除术 (RARC) 会导致严重的术后并发症,66%的患者在90天内出现问题. 较高的手术内输液量与严重并发症相关,强调需要仔细评估和管理患者.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
手术瘤学手术瘤学
最少侵入性的手术

背景情况:

机器人辅助激进囊切除术 (RARC) 是膀癌的标准手术,因为它具有先进的可视化和机动性.
尽管有好处,RARC涉及复杂的步骤,手术后并发症仍然是一个重大问题,特别是在非高容量中心.

研究的目的:

在日本的一个非高体积中心调查RARC后术后并发症的发生率和类型.
确定与体外尿路转移 (ECUD) 和体内尿路转移 (ICUD) 之间的选择相关的因素.

主要方法:

50名连续接受膀癌RARC治疗的患者进行了回顾性,单中心的观察性队列研究 (2019年8月 - 2023年3月).
数据收集包括患者人口统计,手术细节,尿路转移类型和术后并发症 (Clavien-Dindo分类).
统计分析探讨了手术内因素 (如输液量) 和并发症率之间的相关性,以及ECUD选择的原因.

主要成果:

观察到高并发症率:在RARC后90天内66%和30天内62%.
胃肠道问题 (26%) 和尿路感染 (22%) 是最常见的;18%需要在90天内进行手术.
较高的手术内输液量与90天和30天内的重大并发症 (G3+) 有显著的相关性 (分别P=0.025和P=0.0158).

结论:

在非高容量中心RARC后的术后并发症是相当大的,需要注意.
对RARC存在学习曲线,但精细的手术前评估和术后管理可以减轻并发症率,即使在经验较少的中心.

关键词:

克拉维恩-丁多分类系统的分类系统.机器人辅助的激进囊切除术 (RARC)这是一个复杂的并发症.身体外的尿路转移 (ECUD)身体内尿路转移 (ICUD) 是指体内尿路转移.

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