机器人辅助与开放式根治性膀胱切除术：不良住院结果的比较

IF 2 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology Pub Date : 2025-03-28 DOI:10.1002/jso.28108

Francesco Di Bello, Natali Rodriguez Peñaranda, Andrea Marmiroli, Mattia Longoni, Fabian Falkenbach, Quynh Chi Le, Zhe Tian, Jordan A Goyal, Claudia Collà Ruvolo, Gianluigi Califano, Massimiliano Creta, Fred Saad, Shahrokh F Shariat, Stefano Puliatti, Ottavio De Cobelli, Alberto Briganti, Markus Graefen, Felix H K Chun, Nicola Longo, Pierre I Karakiewicz

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引用次数: 0

摘要

目的：量化历史和当代机器人辅助根治性膀胱切除术（RARC）与历史和当代开放式膀胱切除术（ORC）之间不良住院结果的改善。材料和方法：在全国住院患者样本（2010-2019）中，确定了RARC和ORC回肠导管转流患者。拟合了多变量logistic和泊松回归模型。结果：在RARC患者中，1343例（39%）为历史患者（2010-2014年），2087例（61%）为当代患者（2015-2019年）。在ORC患者中，5812例（54%）为历史患者，5019例（46%）为当代患者。与历史对照相比，当代RARC患者在13个类别中的9个类别中表现出明显更好的不良住院结果，术中并发症的改善幅度为-82%，术后累积并发症的改善幅度为-22%。同样，与历史相比，当代ORC患者在13个类别中的9个类别中也表现出明显更好的不良住院结果，从术中并发症的-72%到中位住院时间（LOS）的-12%不等。当将当代RARC与当代ORC进行比较时，13个比较中有7个RARC的不良住院结局更好，从输血改善-55%到中位LOS改善-18%不等。同样，当将历史RARC与历史ORC进行比较时，13个比较中有6个RARC不良住院结局更好，从输血改善-55%到中位LOS改善-15%。结论：在当代RARC与历史RARC（9个改善的类别）以及当代ORC与历史ORC（9个改善的类别）之间，不良住院结果改善的幅度具有可比性。然而，在13类不良住院结局中，当代RARC在7类中优于当代ORC。

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Robot-Assisted Versus Open Radical Cystectomy: Comparison of Adverse In-Hospital Outcomes.

Purpose: To quantify improvements in adverse in-hospital outcomes between historical and contemporary robot-assisted radical cystectomy (RARC) versus historical and contemporary open RC (ORC).

Material and methods: Within the National Inpatient Sample (2010-2019), RARC and ORC ileal conduit diversion patients were identified. Multivariable logistic and Poisson regression models were fitted.

Results: Of RARC patients, 1343 (39%) were historical (2010-2014) and 2087 (61%) were contemporary (2015-2019). Of ORC patients, 5812 (54%) were historical and 5019 (46%) were contemporary. Versus historical counterparts, contemporary RARC patients exhibited significantly better adverse in-hospital outcomes in 9 of 13 categories, with improvements ranging from -82% for intraoperative complications to -22% for cumulative postoperative complications. Similarly, versus historical, contemporary ORC patients also exhibited significantly better adverse in-hospital outcomes in 9 of 13 categories, with improvements ranging from -72% for intraoperative complications to -12% for median length of stay (LOS). When contemporary RARC was compared to contemporary ORC, RARC adverse in-hospital outcomes were better in 7 of 13 comparisons, with improvements ranging from -55% for blood transfusions to -18% for median LOS. Similarly, when historical RARC was compared to historical ORC, RARC adverse in-hospital outcomes were better in 6 of 13 comparisons, with improvements ranging from -55% for blood transfusions to -15% for median LOS.

Conclusion: The magnitude of the improvement in adverse in-hospital outcomes was comparable between contemporary versus historical RARC (nine improved categories) and contemporary versus historical ORC (nine improved categories). However, contemporary RARC outperformed contemporary ORC in 7 of 13 categories of adverse in-hospital outcomes.

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来源期刊

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.