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机器人辅助部分切除术在患有单一脏的患者中的功能结果
Nicolas A Soputro1, Carter D Mikesell1, Salim K Younis1
1Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA.
BJU international
|March 6, 2025
概括
机器人辅助部分切除术 (RAPN) 为患有单一脏的患者和患有两脏的患者提供了可比的长期功能. 然而,孤独脏患者在手术后面临急性损伤 (AKI) 的风险更高.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 机器人手术 机器人手术
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.
- 鉴于脏储备有限,评估单一脏患者的功能结果至关重要.
研究的目的:
- 为了比较RAPN的长期功能结果,在患有单一脏的患者和患有两脏的患者中.
- 在接受RAPN的单独患者中识别不良结果的风险因素.
主要方法:
- 对1698名RAPN患者 (2006-2023) 的前性维护数据库的回顾性审查.
- 倾向性得分匹配分析将单一脏 (n=86) 患者与双侧脏患者进行比较.
- 对年龄,并发症和瘤特征进行控制的分析.
主要成果:
- 与双侧患者相比,单独患者表现出类似的长期功能结果和病进展存活率.
- 在RAPN后3个月的时间里,中位数球过率的保存是可比的 (63.7%与64.7%对比).
- 孤独脏患者的术后急性损伤 (AKI) 发生率显著更高 (79.7%与57.7%相比).
- AKI的独立预测因素包括较低的手术前功能,主动脉紧和温暖缺血时间>25分钟.
结论:
- 对于单一脏患者,RAPN提供了有利的长期功能结果,与双侧脏患者相比.
- 接受RAPN的孤独患者患有术后AKI的风险较高.
- 预先存在的病和长时间的热性缺血时间加剧了这一群体的AKI风险.
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