Retroperitoneal cutaneous ureterostomy following radical cystectomy: A multicenter comparative study of robotic versus open surgery

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology Pub Date : 2024-09-10 DOI:10.1111/iju.15580

Yutaro Sasaki, Kyotaro Fukuta, Fumiya Kadoriku, Kei Daizumoto, Keito Shiozaki, Ryotaro Tomida, Yoshito Kusuhara, Tomoya Fukawa, Yutaka Yanagihara, Ryoichi Nakanishi, Kunihisa Yamaguchi, Yasuyo Yamamoto, Hirofumi Izaki, Masayuki Takahashi, Kenjiro Okamoto, Junya Furukawa

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Abstract

IntroductionThe aim of this study was to evaluate the differences in perioperative outcomes of cutaneous ureterostomy (CUS) between open surgery (open radical cystectomy, ORC) and robot‐assisted surgery (robot‐assisted radical cystectomy, RARC), including the stent‐free rate, readmission rates due to urinary tract infection (UTI), and changes in renal function.MethodsBetween 2005 and 2023, a total of 37 patients underwent CUS following ORC, while 24 patients underwent CUS following RARC. Perioperative outcomes were compared between these two groups.ResultsThe patients in the RARC group were significantly older (p = 0.007) and had a significantly higher proportion of high‐risk cases with ASA‐PS ≥3 (p = 0.002). In addition, RARC was associated with a significantly lower estimated blood loss (p < 0.001) and a reduced transfusion rate (p = 0.003). Postoperative complication rates and the stent‐free rate were comparable between the ORC and RARC groups. Throughout a median follow‐up period of 2.6 years, rates of readmission due to UTI did not differ significantly between the two groups. Moreover, there were no differences in the change in estimated glomerular filtration rate before and after surgery and the 3‐year survival rates were similar across both groups.ConclusionsCUS following RARC appears to offer a safer alternative compared with CUS following ORC, and the stent‐free rates are comparable. The significantly lower estimated blood loss and transfusion rate associated with RARC are particularly favorable for elderly patients, those who are frail, and individuals with multiple comorbidities.

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根治性膀胱切除术后的腹膜后皮下输尿管造口术：机器人手术与开放手术的多中心比较研究

简介：本研究旨在评估开放手术（开放根治性膀胱切除术，ORC）与机器人辅助手术（机器人辅助根治性膀胱切除术，RARC）之间皮下输尿管造口术（CUS）围手术期结果的差异，包括无支架率、尿路感染（UTI）导致的再入院率以及肾功能的变化。方法2005年至2023年间，共有37名患者在ORC术后接受了CUS，24名患者在RARC术后接受了CUS。结果RARC组患者年龄明显偏大（p = 0.007），ASA-PS≥3的高危病例比例明显更高（p = 0.002）。此外，RARC 与估计失血量明显降低（p = 0.001）和输血率降低（p = 0.003）有关。ORC 组和 RARC 组的术后并发症发生率和无支架率相当。在中位 2.6 年的随访期间，两组患者因UTI 再次入院的比例没有显著差异。此外，手术前后估计肾小球滤过率的变化没有差异，两组患者的 3 年生存率相似。与 RARC 相关的估计失血量和输血率明显较低，这对老年患者、体弱者和有多种合并症的患者尤为有利。

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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来源期刊

International Journal of Urology 医学-泌尿学与肾脏学

CiteScore

4.70

自引率

11.50%

发文量

340

审稿时长

3 months

期刊介绍： International Journal of Urology is the official English language journal of the Japanese Urological Association, publishing articles of scientific excellence in urology. Submissions of papers from all countries are considered for publication. All manuscripts are subject to peer review and are judged on the basis of their contribution of original data and ideas or interpretation.