开放式腹膜后原发淋巴结清扫术的当代短期围手术期疗效。

IF 3.7 2区 医学 Q1 UROLOGY & NEPHROLOGY
Jacob D McFadden, Timothy A Masterson, Clint Cary
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引用次数: 0

摘要

目的提供目前开放式原发性腹膜后淋巴结清扫术(RPLND)的围手术期结果和短期并发症发生率,并分析并发症的风险因素:利用印第安纳大学睾丸癌数据库,我们对研究期间(2018-2021 年)接受开放式原发性 RPLND 的所有患者进行了回顾性分析。我们关注的主要结果是接受手术患者的术前概况、并发症发生率以及与并发症相关的风险因素的识别。我们在分析中使用了卡方检验、费雪精确检验和非配对 t 检验:结果:共确定了 165 名患者。体重指数(BMI)中位数为 28.6 kg/m2。患者多为临床 IIA 期(39%)或 IIB 期(36%)睾丸癌。估计失血量中位数为 150 毫升,无需输血。出现任何并发症的患者的体重指数高于恢复正常的患者(34.95 vs 28 kg/m2;P = 0.0042)。住院时间中位数为 3 天。总体并发症发生率较低(8.48%),术后有两例主要并发症,其中一例为乳糜腹水(0.6%),30 天内无死亡病例。该研究因其回顾性设计和短期随访而受到限制:我们发现,即使是在超重人群中,开放式初级 RPLND 的发病率也是可以接受的。失血少、住院时间短、乳糜腹水风险小、术后主要并发症少,这应成为腹膜后淋巴结清扫术的基准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Contemporary short-term peri-operative outcomes of open primary retroperitoneal lymph node dissection.

Objectives: To provide current peri-operative outcomes and short-term complication rates for open primary retroperitoneal lymph node dissection (RPLND), with analysis of risk factors for complications.

Patients and methods: Using the Indiana University Testicular Cancer database, we performed a retrospective analysis of all patients who underwent open primary RPLND over the study period (2018-2021). The primary outcomes of interest were the preoperative profile of patients undergoing surgery, complication rates, and identification of risk factors associated with complications. We used chi-squared, Fisher's exact and unpaired t-tests in our analyses.

Results: A total of 165 patients were identified. The median body mass index (BMI) was 28.6 kg/m2. Patients most often had clinical stage IIA (39%) or IIB testicular cancer (36%). The median estimated blood loss was 150 mL, with no transfusions required. Higher BMI was noted in patients that sustained any complication vs those with normal recovery (34.95 vs 28 kg/m2; P = 0.0042). The median length of hospital stay was 3 days. The overall complication rate was low (8.48%), with two major postoperative complications, including one case of chylous ascites (0.6%), and no deaths in the 30-day period. The study was limited by its retrospective design and short-term follow-up.

Conclusions: We found that open primary RPLND has an acceptable morbidity profile, even among a predominantly overweight cohort. Low blood loss, short hospital stay, minimal chylous ascites risk, and rare major postoperative complications should be the benchmark for retroperitoneal lymph node dissection.

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来源期刊
BJU International
BJU International 医学-泌尿学与肾脏学
CiteScore
9.10
自引率
4.40%
发文量
262
审稿时长
1 months
期刊介绍: BJUI is one of the most highly respected medical journals in the world, with a truly international range of published papers and appeal. Every issue gives invaluable practical information in the form of original articles, reviews, comments, surgical education articles, and translational science articles in the field of urology. BJUI employs topical sections, and is in full colour, making it easier to browse or search for something specific.
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