作为部分瘤切除后伪动脉瘤形成的预测因子的手术内血压和内在瘤特征的评估:一个病例对照研究
Harsha Kaul1, Mitchell M Huang2, Austin P Drysch1
1Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Urologic oncology
|September 3, 2025
概括
部分瘤切除术后的动脉瘤 (RAP) 与瘤大小有关,而不是手术期间的血压. RAP率与最小侵入性技术保持一致.
科学领域:
- 泌尿外科
- 手术并发症
- 肝脏病学
背景情况:
- 动脉伪动脉瘤 (RAP) 是部分切除术 (PN) 后的一种严重并发症,发生在1-2%的病例中.
- 现有文献缺乏关于手术内血压 (BP) 和RAP发展之间的关系的数据.
研究的目的:
- 在部分切除术 (PN) 后,研究手术内血压 (BP) 与动脉伪动脉瘤 (RAP) 的相关性.
- 为了确定PN后RAP形成的风险因素.
主要方法:
- 从2010年到2024年对1400名部分切除 (PN) 患者进行了回顾性分析.
- 使用倾向性比分匹配 (4: 1) 创建了一个对照组,其中31名患者患有RAP.
- 在RAP病例和对照病例之间,最大手术内静脉压 (SBP) 和平均动脉血压 (MAP),缺血时间和瘤复杂性的比较.
主要成果:
- 在1400名PN中,31名 (2.2%) 患有RAP;开放性 (2.6%) 和机器人/透视性 (2.2%) PN的发病率相似.
- 在RAP和对照组之间没有发现缺血时间,瘤复杂性或最大手术内SBP和MAP的显著差异.
- 多变量分析显示,瘤大小增加 (每+1厘米或1. 07) 与RAP相关,而手术内MAP和SBP则不同.
结论:
- 部分切除术后瘤大小,而不是手术期间的血压,是动脉伪动脉瘤形成的重要危险因素.
- 在机器人时代报告的RAP率与历史的最小侵入性数据相比.
- 开放PN后的RAP率可能高于先前记录的.
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