机器人部分切除术后的尿泄漏和血管并发症:当代的单中心体验
Olivia Kola1, Michael Smigelski2, Shavy Nagpal3
1Rutgers New Jersey Medical School, Newark, NJ, USA.
Journal of robotic surgery
|October 29, 2024
概括
在机器人辅助部分切除术后,尿泄漏和血管并发症并不常见. 这些问题往往与高度复杂的瘤有关,可以在不切除脏的情况下有效管理.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 最少侵入性的手术
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 机器人辅助部分切除术 (RAPN) 越来越多地用于瘤治疗.
- 尿泄漏 (UL) 和血管并发症 (VC) 是已知的RAPN的风险.
- 之前的研究报告UL (0.3-17%) 和VC (0.8-5.6%) 的发病率不同.
研究的目的:
- 在RAPN之后报告UL和VC的当代结果在一个高体积的中心.
- 分析与这些并发症相关的患者和瘤特征.
- 描述RAPN后的UL和VC的管理和结果.
主要方法:
- 在2017年1月至2023年5月期间接受RAPN的447名患者的回顾性评估.
- 从IRB批准的脏瘤数据库中收集的数据.
- 分析并发症率,患者人口统计,瘤特征 (脏测量得分,瘤大小,接近收集系统),呈现和管理.
主要成果:
- 确定了9例UL病例 (2.0%) 和9例VC病例 (2.0%).
- VC包括伪动脉瘤和动脉静脉;同时发生了一例VC和UL病例.
- 并发症与高脏测量得分和接近收集系统的瘤有关.
- 呈现于中位数18天后的VCs,通过栓塞管理;呈现于中位数1天后的ULs,通过保守或支架/排水管理.
- 没有患者需要术后输血,脏重新手术或腎切除术.
结论:
- 在RAPN之后,UL和VC的当代比率很低,与其他系列相比.
- 高复杂性瘤 (高脏测量得分,接近收集系统) 与这些并发症有关.
- 早期呈现和有效的管理策略允许保守的治疗,避免损失.
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