Terry Russell S, Gerke Travis, Mason James B, Sorensen Matthew D, Joseph Jason P, Dahm Philipp, Su Li-Ming
Division of Robotic and Minimally Invasive Urologic Surgery, Department of Urology, University of Florida College of Medicine, 1600 SW Archer Road, PO Box 100247, 32610-0247, Gainesville, FL, USA.
Department of Epidemiology, College of Public Health and Health Professions, University of Florida College of Medicine, Gainesville, FL, USA.
J Robot Surg. 2015 Sep;9(3):195-200. doi: 10.1007/s11701-015-0515-2. Epub 2015 Jun 20.
This study aimed at reviewing a contemporary series of patients who underwent robotic renal and adrenal surgery by a single surgeon at a tertiary referral academic medical center over a 6-year period, specifically focusing on the unique and serious complication of post-operative rhabdomyolysis of the dependent lower extremity. The cases of 315 consecutive patients who underwent robotic upper tract surgery over a 6-year period from August 2008 to June 2014 using a standardized patient positioning were reviewed and analyzed for patient characteristics and surgical variables that may be associated with the development of post-operative rhabdomyolysis. The incidence of post-operative rhabdomyolysis in our series was 3/315 (0.95%). All three affected patients had undergone robotic nephroureterectomy. Those patients who developed rhabdomyolysis had significantly higher mean Body Mass Index, Charlson Comorbidity Index, and median length of stay than those who did not. The mean OR time in the rhabdomyolysis group was noted to be 52 min longer than the non-rhabdomyolysis group, though this value did not reach statistical significance. Given the trends of increasing obesity in the United States and abroad as well as the continued rise in robotic upper tract urologic surgeries, urologists need to be increasingly vigilant for recognizing the risk factors and early treatment of the unique complication of post-operative rhabdomyolysis.
本研究旨在回顾一位外科医生在一家三级转诊学术医疗中心，于6年期间为一系列患者实施机器人肾脏和肾上腺手术的情况，特别关注术后下肢横纹肌溶解这一独特且严重的并发症。回顾并分析了2008年8月至2014年6月期间连续315例接受机器人上尿路手术患者的病例，这些患者采用标准化的患者体位，分析其可能与术后横纹肌溶解发生相关的患者特征和手术变量。我们系列研究中术后横纹肌溶解的发生率为3/315（0.95%）。所有3例受影响患者均接受了机器人肾输尿管切除术。发生横纹肌溶解的患者的平均体重指数、查尔森合并症指数和中位住院时间均显著高于未发生者。横纹肌溶解组的平均手术时间比非横纹肌溶解组长52分钟，不过该数值未达到统计学意义。鉴于美国国内外肥胖率不断上升以及机器人上尿路泌尿外科手术持续增加的趋势，泌尿外科医生需要更加警惕识别术后横纹肌溶解这一独特并发症的危险因素并尽早治疗。
