Outcomes of robotic-assisted radical nephrectomy during service implementation: Lessons from an audit.

IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Samvel Nikoghosyan, Aristeidis Alevizopoulos, Sheikh Nissar Ahmad, Ezgi Aldemir, Arian Arjomandi Rad, Robert Vardanyan
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引用次数: 0

Abstract

Background: Robot-assisted surgery (RAS) is an extension of minimally invasive surgery rapidly gaining acceptance in many conditions. The study aims to assess and share lessons impact of RAS on the radical nephrectomy (RN) service during the implementation phase.

Methods: Two separate analyses were carried out: to compare the outcome of all RN - before and after the implementation of RAS regardless of surgical mode, and a direct comparison between two minimal invasive approaches: Robotic-assisted radical nephrectomies (RARNs) and Laparoscopic radical nephrectomies (LRNs).

Results: The study included 55 pre- and 45 robotic era RNs: 45 RARNs, 48 LRNs and 7 open radical nephrectomies (ORNs). Following RAS implementation, all RNs transitioned to RARNs. The broader comparison of all RNs in the robotic versus pre-robotic periods revealed significant reductions in estimated blood loss and the length of hospital stay, though operative times were notably longer. In the direct comparison between LRNs and RARNs, no major differences in perioperative outcomes were noted, except for a significantly longer duration of surgery in the RARN group.

Conclusion: The introduction of the robotic platform resulted in a paradigm shift in RN service, eliminating ORN and LRN. Despite increasing operative duration, RARNs improved certain perioperative outcomes (specifically length of stay and blood loss) and were favoured over other modalities.

服务实施期间机器人辅助根治性肾切除术的结果:来自审计的经验教训。
背景:机器人辅助手术(RAS)是微创手术的延伸,在许多情况下迅速得到认可。本研究旨在评估RAS在实施阶段对根治性肾切除术(RN)服务的影响并分享经验教训。方法:分别进行两项分析:比较不同手术方式实施RAS前后所有肾切除术的预后;直接比较两种微创入路:机器人辅助根治性肾切除术(RARNs)和腹腔镜根治性肾切除术(LRNs)。结果:研究包括55例机器人时代前肾切除术和45例机器人时代肾切除术,其中45例为RARNs, 48例为LRNs, 7例为开放式根治性肾切除术。在RAS实现之后,所有RNs都转换为RNs。更广泛地比较机器人时期与机器人之前的所有RNs,发现估计失血量和住院时间显著减少,尽管手术时间明显更长。在LRNs和RARNs的直接比较中,除了RARN组的手术时间明显更长外,围手术期结果没有明显差异。结论:机器人平台的引入导致了RN服务的范式转变,消除了ORN和LRN。尽管增加了手术时间,RARNs改善了某些围手术期结果(特别是住院时间和出血量),比其他模式更受青睐。
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
Scottish Medical Journal
Scottish Medical Journal 医学-医学:内科
CiteScore
4.80
自引率
3.70%
发文量
42
审稿时长
>12 weeks
期刊介绍: A unique international information source for the latest news and issues concerning the Scottish medical community. Contributions are drawn from Scotland and its medical institutions, through an array of international authors. In addition to original papers, Scottish Medical Journal publishes commissioned educational review articles, case reports, historical articles, and sponsoring society abstracts.This journal is a member of the Committee on Publications Ethics (COPE).
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