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机器人辅助腹腔镜与开放根治性膀胱切除术治疗 200 例患者的并发症和围手术期肿瘤学结果比较。

Robot-assisted laparoscopic vs open radical cystectomy: comparison of complications and perioperative oncological outcomes in 200 patients.

机构信息

Division of Urology, UC San Diego Heath System, San Diego, CA, USA.

出版信息

BJU Int. 2013 Aug;112(4):E290-4. doi: 10.1111/bju.12167. Epub 2013 Jul 1.

Abstract

OBJECTIVE

To compare perioperative morbidity and oncological outcomes of robot-assisted laparoscopic radical cystectomy (RARC) to open RC (ORC) at a single institution.

PATIENTS AND METHODS

A retrospective analysis was performed on a consecutive series of patients undergoing RC (100 RARC and 100 ORC) at Wake Forest University with curative intent from 2006 until 2010. Complication data using the Clavien system were collected for 90 days postoperatively. Complications and other perioperative outcomes were compared between patient groups.

RESULTS

Patients in both groups had comparable preoperative characteristics. The overall and major complication (Clavien ≥ 3) rates were lower for RARC patients at 35 vs 57% (P = 0.001) and 10 vs 22% (P = 0.019), respectively. There were no significant differences between groups for pathological outcomes, including stage, number of nodes harvested or positive margin rates.

CONCLUSION

Our data suggest that patients undergoing RARC have perioperative oncological outcomes comparable with ORC, with fewer overall or major complications. Definitive claims about comparative outcomes with RARC require results from larger, randomised controlled trials.

摘要

目的

比较单中心机器人辅助腹腔镜根治性膀胱切除术(RARC)与开放性根治性膀胱切除术(ORC)的围手术期发病率和肿瘤学结果。

患者和方法

回顾性分析了威克森林大学 2006 年至 2010 年间连续接受根治性膀胱切除术(100 例 RARC 和 100 例 ORC)的患者的连续系列。术后 90 天收集 Clavien 系统的并发症数据。比较两组患者的并发症和其他围手术期结局。

结果

两组患者的术前特征相似。RARC 组的总并发症(Clavien≥3)和主要并发症(Clavien≥3)发生率分别为 35%和 10%,明显低于 ORC 组的 57%和 22%(P=0.001 和 P=0.019)。两组在病理结果方面,包括分期、淋巴结清扫数目或阳性切缘率均无显著差异。

结论

我们的数据表明,接受 RARC 的患者具有与 ORC 相当的围手术期肿瘤学结果,且总并发症或主要并发症更少。需要更大规模、随机对照试验的结果来确定 RARC 比较结果的明确结论。

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