腹腔外与腹腔内机器人辅助根治性前列腺切除术的安全性和围手术期结果：来自单一区域中心的倾向评分匹配研究

IF 2.4 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford Pub Date : 2025-09-08 DOI:10.1016/j.suronc.2025.102292

Atsushi Igarashi, Riki Obayashi, Akihiro Yamamoto, Akihiko Nagoshi, Tasuku Fujiwara, Naoki Akagi, Yuto Hattori, Noboru Shibasaki, Mutsushi Kawakita, Toshinari Yamasaki

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引用次数: 0

摘要

目的比较我院机器人辅助根治性前列腺切除术（RARP）中经腹腔入路（Tp）和腹腔外入路（Ep）的围手术期预后和并发症。方法回顾性分析2014年至2023年间894例RARP患者的数据，其中539例Ep患者和355例Tp患者。不需要扩展淋巴结清扫（ELND）的患者选择Ep，而需要ELND的患者选择Tp。进行倾向得分匹配（PSM），得到326对匹配。主要结局包括严重并发症（Clavien-Dindo III级或更高）。次要结果包括输血率、无ELND的安慰时间和术后住院时间。结果经PSM治疗后，Ep组出现严重并发症0例（0%），Tp组出现严重并发症14例（4.3%），Tp组出现肠道相关并发症较多。两组输血率均较低（0.6% [Ep] vs. 0% [Tp], p = 0.43）。手术参数显示无ELND的控制台时间（185 min [Ep] vs. 179 min [Tp], p = 0.30）。术后住院时间组间比较（中位数均为6天，p = 0.05）。Ep组19%的患者出现腹膜损伤，但大多数病例未导致严重并发症或转化为Tp。结论本研究提示Tp和Ep都是RARP的可行方法，Ep可能与较少的肠道并发症相关。

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Safety and perioperative outcomes in extraperitoneal versus transperitoneal robot-assisted radical prostatectomy: A propensity score matching study from a single regional center

Objectives

This study aimed to compare perioperative outcomes and complications between the transperitoneal approach (Tp) and extraperitoneal approach (Ep) in robot-assisted radical prostatectomy (RARP) at our institution.

Methods

We retrospectively reviewed data from 894 patients who underwent RARP between 2014 and 2023, including 539 with Ep and 355 with Tp. Ep was selected for patients who did not require extended lymph node dissection (ELND), whereas Tp was selected for patients who required ELND. Propensity score matching (PSM) was performed, resulting in 326 matched pairs. Primary outcomes included severe complications (Clavien–Dindo grade III or higher). Secondary outcomes included transfusion rates, console time without ELND and postoperative length of stay.

Results

Following PSM, severe complications occurred in 0 patients (0 %) in the Ep group and in 14 patients (4.3 %) in the Tp group, with bowel-related complications more frequent in the latter. The transfusion rate was low in both groups (0.6 % [Ep] vs. 0 % [Tp], p = 0.43). Operative parameters showed comparable console time without ELND (185 min [Ep] vs. 179 min [Tp], p = 0.30). Postoperative length of stay was comparable between groups (median, 6 days for both; p = 0.05). Peritoneal injuries occurred in 19 % of patients in the Ep group but did not lead to major complications or conversion to Tp in most cases.

Conclusions

This study suggests that both Tp and Ep are feasible approaches for RARP, with Ep potentially associated with fewer bowel complications.

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来源期刊

Surgical Oncology-Oxford 医学-外科

CiteScore

4.50

自引率

0.00%

发文量

169

审稿时长

38 days

期刊介绍： Surgical Oncology is a peer reviewed journal publishing review articles that contribute to the advancement of knowledge in surgical oncology and related fields of interest. Articles represent a spectrum of current technology in oncology research as well as those concerning clinical trials, surgical technique, methods of investigation and patient evaluation. Surgical Oncology publishes comprehensive Reviews that examine individual topics in considerable detail, in addition to editorials and commentaries which focus on selected papers. The journal also publishes special issues which explore topics of interest to surgical oncologists in great detail - outlining recent advancements and providing readers with the most up to date information.