输尿管镜检查上尿路上皮癌的累积发病率。

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引用次数: 0

摘要

目的:评估输尿管镜检查(URS)治疗上尿路上皮癌(UTUC)后的并发症,并使用综合并发症指数(CCI)评估术后累积发病率:单中心回顾性研究,包括因怀疑UTUC而接受URS的患者。URS包括诊断性URS和手术性URS。根据EAU指南记录术后并发症,并根据克拉维恩-丁多分类法(CDC)进行分级。使用 CCI 评估了发生多次并发症的患者的累积术后发病负担。多变量逻辑回归(MLR)分析确定了与术后发生任何等级并发症和主要并发症独立相关的因素:共纳入 360 名疑似 UTUC 患者,进行了 575 次 URS。所有术后并发症的累计记录为 111 例。在86例(15%)手术中,患者至少出现了一种术后并发症,25例(4.3%)出现了一种以上的并发症。其中,16 例(14%)为严重并发症(CDC ≥ IIIa)。最常见的并发症类型是泌尿系统(34%)、出血(30%)和感染(30%)。CDC 等级越高,CCI 中位数越高,从 CDC II 到主要并发症,CCI 中位数有显著的统计学增长。术中出现并发症的患者在MLR时出现任何级别和主要术后并发症的风险更高:结论:UTUC输尿管镜检查后的并发症相对少见。结论:UTUC 输尿管镜检查术后并发症相对少见,术中出现并发症的患者术后出现并发症的风险更高。综合并发症指数似乎比克拉维恩-丁多分类法更能代表术后累积发病率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cumulative morbidity of ureteroscopy for upper tract urothelial carcinoma

Objective

To assess complications after ureteroscopy (URS) for upper tract urothelial carcinoma (UTUC) management and to assess its postoperative cumulative morbidity burden using the Comprehensive Complication Index (CCI).

Materials and methods

Single center retrospective study including patients submitted to URS for UTUC suspicion. URSs were both diagnostic and operative. Postoperative complications were recorded according to the EAU Guidelines and graded according to Clavien-Dindo Classification (CDC). The cumulative postoperative morbidity burden developed by patients experiencing multiple events was assessed using the CCI. Multivariable logistic regression (MLR) analyses identified factors independently associated with the development of any grade and major postoperative complications.

Results

Overall, 360 patients with UTUC suspicion were included with a total of 575 URSs performed. The cumulative number of all postoperative complications recorded was 111. In 86 (15%) procedures, patients experienced at least one postoperative complication, while 25 (4.3%) experienced more than one complication. Of these, 16 (14%) were severe (CDC ≥ IIIa). The most frequent type of complications were urinary (34%), bleeding (30%) and infectious (30%). The higher the CDC grade, the higher the median CCI, with a statistically significant increase in median CCI from CDC II to major complications. Patients who experienced intraoperative complications were at higher risk of developing any grade and major postoperative complications at MLR.

Conclusions

Complications after ureteroscopy for UTUC are relatively uncommon events. Patients who experience intraoperative complications are at higher risk of developing postoperative complications. The comprehensive complication index appeared more representative of the cumulative postoperative morbidity rather than the Clavien-Dindo classification.
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