根源性囊切术后静脉血栓栓塞:开放式与机器人方法的系统比较 (2003-2025年)
Ahmed Abdelrasheed1, Adnan Higgi2, Abdelrahman Elkomy3
1Urology, Royal Glamorgan Hospital, Pontyclun, GBR.
Cureus
|November 12, 2025
概括
与开放式手术相比,机器人辅助的激进囊切除显著降低了静脉血栓栓塞 (VTE) 的风险. 适当的VTE预防对于所有接受激进囊切除术的患者至关重要.
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
- 心血管医学 心血管医学
背景情况:
- 激进囊切除术是膀癌的重大手术,与静脉血栓塞栓症 (VTE) 的高风险有关.
- 在此过程中,VTE对术后的发病率和死亡率有显著的贡献.
研究的目的:
- 系统地审查和比较开放激进囊切除术 (ORC) 和机器人辅助激进囊切除术 (RARC) 之间的血栓性并发症的发生率.
- 确定VTE的预测因子,并评估不同预防策略的有效性.
主要方法:
- 根据PRISMA 2020指南进行了系统审查.
- 在2003-2025年期间搜索了主要的数据库 (PubMed/MEDLINE,EMBASE,Cochrane,SCOPUS,Web of Science)
- 包括31项涉及12,847名成年患者的研究,重点关注报告的深静脉血栓形成 (DVT) 或VTE发生率和手术方法.
主要成果:
- 机器人辅助激进囊切除术 (RARC) 与开放激进囊切除术 (ORC) (3.2-11.5%) 相比,显示了明显较低的DVT率 (0-5.6%).
- 分析证实ORC有更高的血栓形成风险 (OR:1.65).
- 预测VTE的因素包括先前的VTE,COPD,晚期癌症和肥胖. 长期预防 (28天) 减少了58%的静脉瘤.
结论:
- 与ORC相比,RARC与VTE的风险明显较低.
- 有效的VTE预防,包括延长时间和考虑口服抗凝剂,无论手术方法如何,都是必不可少的.
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