确定体外尿路转流术和体外尿路转流术与机器人膀胱切除术围手术期结果的风险因素。

IF 3.1 3区 医学 Q1 UROLOGY & NEPHROLOGY
Hangcheng Fu, Laura Davis, Venkat Ramakrishnan, Thomas Barefoot, Colleen Sholtes, Lifan Liang, Mohammed Said, Jamie Messer
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引用次数: 0

摘要

导言:体外尿路改道(ICUD)机器人辅助膀胱切除术尽管非常复杂,但其采用率却越来越高,这促使我们将其与体外尿路改道(ECUD)进行详细比较。我们在一家医疗机构进行的研究调查了围手术期的结果,并确定了影响这些手术方法成功的风险因素:在这项回顾性分析中,我们回顾了 2016 年 6 月至 2021 年 8 月期间在路易斯维尔大学接受机器人辅助膀胱切除术的 174 名患者。根据尿流改道方法将患者分为两组:30名患者接受了ECUD,144名患者接受了ICUD。对人口统计学、并发症发生率、住院时间和再入院率等数据进行了细致的收集和分析:ICUD组和ECUD组的手术时间相当。结果:ICUD 组和 ECUD 组的手术时间相当,但 ICUD 组的术中输血率明显更低(0.5 对 1.0,P=0.02),住院时间更短(7.8 对 12.3 天,P=0.01):与ECUD相比,ICUD机器人膀胱切除术的住院时间更短,术中输血率更低,但在手术时间、高级别术后并发症或再入院率方面没有差异。这些发现可为临床决策提供参考,在适当的情况下,ICUD可能是更有利的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Identify risk factors for perioperative outcomes in Intracorporeal Urinary Diversion and Extracorporeal Urinary Diversion with Robotic Cystectomy.

Introduction: The increasing adoption of robotic-assisted cystectomy with intracorporeal urinary diversion (ICUD), despite its complexity, prompts a detailed comparison with extracorporeal urinary diversion (ECUD). Our study at a single institution investigates perioperative outcomes and identifies risk factors impacting the success of these surgical approaches.

Methods: In this retrospective analysis, 174 patients who underwent robotic-assisted cystectomy at the University of Louisville from June 2016 to August 2021 were reviewed. The cohort was divided into two groups based on the urinary diversion method: 30 patients underwent ECUD and 144 underwent ICUD. Data on demographics, complication rates, length of hospital stay, and readmission rates were meticulously collected and analyzed.

Results: Operative times were comparable between the ICUD and ECUD groups. However, the ICUD group had a significantly lower intraoperative transfusion rate (0.5 vs. 1.0, p=0.02) and shorter hospital stay (7.8 vs. 12.3 days, p<0.001). Factors such as male sex, smoking history, diabetes mellitus, intravesical therapy, higher ASA, and ACCI scores were associated with increased Clavien-Dindo Grade 3 or higher complications. Age over 70 was the sole factor linked to a higher 90-day readmission rate, with no specific characteristics influencing the 30-day rate.

Conclusion: Robotic cystectomy with ICUD results in shorter hospitalizations and lower intraoperative transfusion rates compared to ECUD, without differences in operative time, high-grade postoperative complications, or readmission rates. These findings can inform clinical decision-making, highlighting ICUD as a potentially more favorable option in appropriate settings.

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来源期刊
International Braz J Urol
International Braz J Urol UROLOGY & NEPHROLOGY-
CiteScore
4.60
自引率
21.60%
发文量
246
审稿时长
6-12 weeks
期刊介绍: Information not localized
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