打捞机器人辅助根治性膀胱切除术对有盆腔放疗史的患者是安全的。

IF 1.3 4区 医学 Q4 UROLOGY & NEPHROLOGY
Current Urology Pub Date : 2025-07-01 Epub Date: 2025-04-11 DOI:10.1097/CU9.0000000000000279
James Kovacic, Ankur Dhar, Jonathan Kam, Andrew Shepherd, Ahmed Goolam, Matthew Winter
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引用次数: 0

摘要

目的:描述一项多中心系列研究的手术入路和围手术期结果,评估机器人辅助入路在盆腔放疗背景下根治性膀胱切除术合并全体内尿转移。材料和方法:我们分析了2018年至2022年间放疗后接受机器人辅助根治性膀胱切除术的膀胱癌患者的前瞻性膀胱切除术数据库。通过查阅电子病历收集患者的人口学信息和术前因素数据,包括疾病分期、术前肾积水和盆腔放疗史。所有手术均由2名经验丰富的泌尿科医生中的1名使用达芬奇X、Xi或Si手术平台进行。结果:本研究确定了10例患者。参与者的中位年龄为73.5岁(范围41-84岁)。美国麻醉医师学会分类评分中位数为3分(范围3-4)。Charlson共病指数中位数为6(范围2-12)。其中,10例患者中有4例(40%)在挽救手术前患有肌肉浸润性膀胱癌。8例患者行体外回肠导管导尿术,2例患者行体外新膀胱形成术。术中出血量中位数为250 mL(范围150 ~ 600 mL),中位手术时间390分钟(范围195 ~ 450分钟)。总的30天并发症发生率为60%,Clavien-Dindo≥3级并发症发生率为15%。围手术期死亡率为0%。中位随访时间为210天(范围60-1580天)。结论:这一系列描述了机器人辅助的全体内尿转移根治性膀胱切除术的结果,证明了该技术的安全性。需要进一步的长期随访研究,包括肿瘤学结果,以支持该手术的广泛采用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Salvage robotic-assisted radical cystectomy is safe in patients with history of pelvic irradiation.

Salvage robotic-assisted radical cystectomy is safe in patients with history of pelvic irradiation.

Salvage robotic-assisted radical cystectomy is safe in patients with history of pelvic irradiation.

Salvage robotic-assisted radical cystectomy is safe in patients with history of pelvic irradiation.

Objectives: To describe the surgical approach and perioperative outcomes of a multicenter series evaluating a robotic-assisted approach to radical cystectomy with total intracorporeal urinary diversion in the setting of prior pelvic radiotherapy.

Materials and methods: We analyzed our prospective cystectomy database for patients who underwent robotic-assisted radical cystectomy for bladder cancer after radiotherapy between 2018 and 2022. Demographic information and data regarding preoperative factors including stage of disease, preoperative hydronephrosis, and history of pelvic radiotherapy were collected via review of electronic medical records. All operations were performed by 1 of 2 experienced urologists using the da Vinci X, Xi, or Si surgical platforms.

Results: Ten patients were identified for this study. The median age of participants was 73.5 years (range, 41-84 years). The median American Society of Anesthesiologists classification score was 3 (range, 3-4). The median Charlson Comorbidity Index was 6 (range, 2-12). Among the patients, 4 out of 10 patients (40%) had muscle invasive bladder cancer before salvage surgery. Intracorporeal ileal conduit urinary diversion was performed in 8 patients, whereas 2 patients underwent intracorporeal neobladder formation. Median intraoperative blood loss was 250 mL (range, 150-600 mL), and median operative duration was 390 minutes (range, 195-450 minutes). The overall 30-day complication rate was 60% with a Clavien-Dindo grade ≥3 complication rate of 15%. Perioperative mortality was 0%. Median duration of follow-up was 210 days (range, 60-1580 days).

Conclusions: This series describing the outcomes of salvage robotic-assisted radical cystectomy using total intracorporeal urinary diversion demonstrates the safety of this technique. Further studies with long-term follow-up, including oncological outcomes, are required to support the widespread adoption of this procedure.

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来源期刊
Current Urology
Current Urology Medicine-Urology
CiteScore
2.30
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发文量
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