Engin Derekoylu, Mustafa Ozkaya, Mustafa Macit, Goktug Kalender, Kadir Can Sahin, M Hamza Gultekin, Cetin Demirdag, Bulent Onal
{"title":"机器人辅助腹腔镜根治性前列腺切除术后发生切口疝的风险因素评估","authors":"Engin Derekoylu, Mustafa Ozkaya, Mustafa Macit, Goktug Kalender, Kadir Can Sahin, M Hamza Gultekin, Cetin Demirdag, Bulent Onal","doi":"10.1089/lap.2024.0106","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Objective:</i></b> Our aim was to evaluate patient-related factors and compare the techniques used for surgical specimen removal [trocar extension (TE) and Pfannenstiel incision (PF)] in terms of incisional hernia (IH) occurrence in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALRP). <b><i>Materials and Methods:</i></b> The records of 219 patients who underwent RALRP in our clinic between November 2017 and March 2021 were analyzed retrospectively. Postoperative complication data and functional (continence and potency status) and oncological outcomes were recorded. Hernia type, location, and treatments applied were also noted. <b><i>Results:</i></b> After exclusion, complete data were available on 192 patients undergoing RALRP between the specified dates. The TE technique for removing the surgical specimen was performed in 135 patients, and the lower abdominal transverse incision technique (PF) in 57 patients. Preoperative patient- and tumor-related characteristics (age, body mass index [BMI], American Society of Anesthesiologists (ASA) score, T stage, and prostate size) were similar in both surgical groups. IH was detected in 16 patients (14 in the TE group and 2 in the PF group) (<i>P</i> = .156). Thirteen patients underwent surgery for IH, and three were followed up clinically. <b><i>Conclusion:</i></b> In our study, no statistically significant demographic or surgical technique-related factors were found to explain the occurrence of IH in patients who underwent RALRP for prostate cancer. It was observed that IH occurred more frequently in the cases where the surgical specimen was removed with the TE technique compared with the PF incision, but this result was not statistically significant. There was also no statistically significant difference between these two groups regarding oncological and functional outcomes in the early postoperative period.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluation of the Risk Factors for the Incisional Hernia Occurrence After Robot-Assisted Laparoscopic Radical Prostatectomy.\",\"authors\":\"Engin Derekoylu, Mustafa Ozkaya, Mustafa Macit, Goktug Kalender, Kadir Can Sahin, M Hamza Gultekin, Cetin Demirdag, Bulent Onal\",\"doi\":\"10.1089/lap.2024.0106\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Objective:</i></b> Our aim was to evaluate patient-related factors and compare the techniques used for surgical specimen removal [trocar extension (TE) and Pfannenstiel incision (PF)] in terms of incisional hernia (IH) occurrence in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALRP). <b><i>Materials and Methods:</i></b> The records of 219 patients who underwent RALRP in our clinic between November 2017 and March 2021 were analyzed retrospectively. Postoperative complication data and functional (continence and potency status) and oncological outcomes were recorded. Hernia type, location, and treatments applied were also noted. <b><i>Results:</i></b> After exclusion, complete data were available on 192 patients undergoing RALRP between the specified dates. The TE technique for removing the surgical specimen was performed in 135 patients, and the lower abdominal transverse incision technique (PF) in 57 patients. Preoperative patient- and tumor-related characteristics (age, body mass index [BMI], American Society of Anesthesiologists (ASA) score, T stage, and prostate size) were similar in both surgical groups. IH was detected in 16 patients (14 in the TE group and 2 in the PF group) (<i>P</i> = .156). Thirteen patients underwent surgery for IH, and three were followed up clinically. <b><i>Conclusion:</i></b> In our study, no statistically significant demographic or surgical technique-related factors were found to explain the occurrence of IH in patients who underwent RALRP for prostate cancer. It was observed that IH occurred more frequently in the cases where the surgical specimen was removed with the TE technique compared with the PF incision, but this result was not statistically significant. 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引用次数: 0
摘要
目的:我们的目的是评估患者相关因素,并比较机器人辅助腹腔镜前列腺癌根治术(RALRP)患者手术标本清除技术(套管延长(TE)和Pfannenstiel切口(PF))对切口疝(IH)发生率的影响。材料与方法:回顾性分析2017年11月至2021年3月期间在我院接受RALRP手术的219例患者的病历。记录了术后并发症数据、功能(尿失禁和排尿能力状态)和肿瘤结果。此外,还记录了疝气类型、位置和治疗方法。结果经过排除,在规定日期内接受 RALRP 手术的 192 位患者的完整数据均已获得。135名患者采用TE技术切除手术标本,57名患者采用下腹横切口技术(PF)。两组患者的术前特征和肿瘤相关特征(年龄、体重指数[BMI]、美国麻醉医师协会(ASA)评分、T分期和前列腺大小)相似。16例患者(TE组14例,PF组2例)检测到IH(P = .156)。13 名患者接受了 IH 手术,3 名患者接受了临床随访。结论在我们的研究中,没有发现与人口统计学或手术技术相关的重要因素可以解释前列腺癌 RALRP 患者 IH 的发生。据观察,与 PF 切口相比,采用 TE 技术切除手术标本的病例发生 IH 的频率更高,但这一结果并无统计学意义。在术后早期的肿瘤和功能结果方面,两组之间也没有统计学意义上的显著差异。
Evaluation of the Risk Factors for the Incisional Hernia Occurrence After Robot-Assisted Laparoscopic Radical Prostatectomy.
Objective: Our aim was to evaluate patient-related factors and compare the techniques used for surgical specimen removal [trocar extension (TE) and Pfannenstiel incision (PF)] in terms of incisional hernia (IH) occurrence in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALRP). Materials and Methods: The records of 219 patients who underwent RALRP in our clinic between November 2017 and March 2021 were analyzed retrospectively. Postoperative complication data and functional (continence and potency status) and oncological outcomes were recorded. Hernia type, location, and treatments applied were also noted. Results: After exclusion, complete data were available on 192 patients undergoing RALRP between the specified dates. The TE technique for removing the surgical specimen was performed in 135 patients, and the lower abdominal transverse incision technique (PF) in 57 patients. Preoperative patient- and tumor-related characteristics (age, body mass index [BMI], American Society of Anesthesiologists (ASA) score, T stage, and prostate size) were similar in both surgical groups. IH was detected in 16 patients (14 in the TE group and 2 in the PF group) (P = .156). Thirteen patients underwent surgery for IH, and three were followed up clinically. Conclusion: In our study, no statistically significant demographic or surgical technique-related factors were found to explain the occurrence of IH in patients who underwent RALRP for prostate cancer. It was observed that IH occurred more frequently in the cases where the surgical specimen was removed with the TE technique compared with the PF incision, but this result was not statistically significant. There was also no statistically significant difference between these two groups regarding oncological and functional outcomes in the early postoperative period.
期刊介绍:
Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.