Impact of Polypharmacy on Perioperative Outcomes of Robot-assisted Laparoscopic Partial Nephrectomy for Small Renal Masses.

IF 1.8 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

In vivo Pub Date : 2025-09-01 DOI:10.21873/invivo.14079

Yuki Nemoto, Hiroki Ishihara, Kazutaka Nakamura, Koichi Nishimura, Hironori Fukuda, Kazuhiko Yoshida, Junpei Iizuka, Tsunenori Kondo, Toshio Takagi

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引用次数: 0

Abstract

Background/aim: To clarify the relationship between polypharmacy and perioperative outcomes in patients undergoing robot-assisted laparoscopic partial nephrectomy (RAPN) for small renal masses.

Patients and methods: The clinical data of 2,392 patients who underwent RAPN for clinical T1 renal masses between January 2013 and November 2023 were retrospectively assessed. Polypharmacy was defined as patients taking five or more oral medications at the time of surgery. Perioperative outcomes were compared based on the polypharmacy status by balancing possible biases between the polypharmacy and non-polypharmacy groups using the propensity score matching (PSM) approach.

Results: Of 2,392 patients, 669 (28.0%) were classified into the polypharmacy group. After PSM, 532 non-polypharmacy patients were matched to the polypharmacy group. Patients in the polypharmacy group had a higher risk of perioperative complications (p=0.022) and a longer postoperative hospital stay (p=0.048) than those in the non-polypharmacy group. Additionally, the rate of intraoperative blood transfusions was higher in the polypharmacy group than in the non-polypharmacy group (p=0.088).

Conclusion: Polypharmacy was significantly associated with inverse perioperative outcomes in patients who underwent RAPN for small renal masses. This can aid in determining optimal surgical indications and postoperative monitoring of RAPN.

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多药对机器人辅助腹腔镜部分肾切除术治疗小肾肿块围手术期疗效的影响。

背景/目的：阐明机器人辅助腹腔镜部分肾切除术（RAPN）患者多药治疗与围手术期预后的关系。患者与方法：回顾性分析2013年1月至2023年11月2392例临床T1型肾肿块行RAPN的患者的临床资料。多药被定义为患者在手术时服用五种或更多的口服药物。采用倾向评分匹配（PSM）方法，通过平衡多药组和非多药组之间可能存在的偏差，比较围手术期结果。结果：2392例患者中，669例（28.0%）分为综合用药组。经PSM后，532例非综合用药组患者与综合用药组相匹配。综合用药组患者围手术期并发症发生率高于非综合用药组（p=0.022），术后住院时间长于非综合用药组（p=0.048）。综合用药组术中输血率高于非综合用药组（p=0.088）。结论：多药治疗与小肾肿块行RAPN患者围手术期的不良预后显著相关。这有助于确定最佳手术指征和术后监测RAPN。

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

In vivo 医学-医学：研究与实验

CiteScore

4.20

自引率

4.30%

发文量

330

审稿时长

3-8 weeks

期刊介绍： IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management. The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.