State of art of robotic prostatectomy: the way we do it in Catalonia, Spain

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Abstract

Introduction and objective

Robotic-assisted laparoscopic prostatectomy (PLAR) seems to improve functional outcomes, however there is not a consensus of a standard procedure. The aim of this study was to identify the PLAR “state of art” in Catalonia, Spain.

Material and methods

This was a cross-sectional survey-based study conducted among urologists across Catalonia, Spain. The survey was distributed through online platforms and the professional urology society. All statistical analyses were performed using Stata software, v20.

Results

59 urologists completed the survey, revealing PLAR as the most commonly used technique (79.7%). Most urologist (70%) create the pneumoperitoneum using a controlled incision with direct access and 78.3% use the Airseal technology. The intraperitoneal approach is performed in >90% of cases. Endopelvic fascia preservation is not routinely performed. 34.5% of the survey not perform the dorsal vein complex suture. All preserves the bladder neck when oncologically safe. Nerve-vascular bundles bleeding control is performed using standard coagulation or suturing. 34% performed posterior reconstruction. Only use hemostatic devices when evident bleeding and 70% does not routinely left a drainage.
Multivariable analysis showed that center volume had a significant independent association with dorsal venous complex suturing (OR 0.073, 95%CI 0.07−0.826), nerve-vascular bundles suturing hemostasis (OR 11.67, 95%CI 1.07−127.60) and endopelvic fascia preservation (OR 13.64, 95%CI 1.087–201.27), but there was no correlation with time the bladder catheter or days hospitalized.

Conclusions

The study provides an overview of the state of PLAR in Catalonia, Spain, showing significant variability and reflecting a commitment to advancing surgical technology and patient care.
机器人前列腺切除术的最新进展:西班牙加泰罗尼亚地区的情况如何?
简介和目的:机器人辅助腹腔镜前列腺切除术(PLAR)似乎能改善功能性结果,但目前尚未就标准手术达成共识。本研究旨在确定西班牙加泰罗尼亚地区前列腺切除术的 "技术水平":这是一项以横断面调查为基础的研究,调查对象为西班牙加泰罗尼亚地区的泌尿科医生。调查通过在线平台和专业泌尿外科学会进行。所有统计分析均使用 Stata 软件 v20 进行:59 名泌尿科医生完成了调查,结果显示 PLAR 是最常用的技术(79.7%)。大多数泌尿科医生(70%)使用直接进入的可控切口创建腹腔积气,78.3%的医生使用 Airseal 技术。超过90%的病例采用腹腔内方法。骨盆内筋膜保留不是常规做法。34.5%的调查未进行背静脉复合缝合。在肿瘤学安全的情况下,全部保留膀胱颈。使用标准凝固或缝合术控制神经血管束出血。34%进行后方重建。只有在明显出血时才使用止血装置,70%的患者不会常规留置引流管。多变量分析显示,中心容积与背静脉复合缝合(OR 0.073,95%CI 0.07-0.826)、神经血管束缝合止血(OR 11.67,95%CI 1.07-127.60)和骨盆内筋膜保留(OR 13.64,95%CI 1.087-201.27)有显著的独立关联,但与膀胱导尿时间或住院天数没有相关性:本研究概述了西班牙加泰罗尼亚地区 PLAR 的现状,显示出显著的差异性,并反映了该地区致力于提高手术技术和患者护理水平的决心。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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