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既往腹部手术对机器人辅助腹腔镜根治性前列腺切除术术后结局的影响:单中心经验

Impact of prior abdominal surgery on the outcomes after robotic - assisted laparoscopic radical prostatectomy: single center experience.

作者信息

Kishimoto Nozomu, Takao Tetsuya, Yamamichi Gaku, Okusa Takuya, Taniguchi Ayumu, Tsutahara Koichi, Tanigawa Go, Yamaguchi Seiji

机构信息

Osaka General Medical Center-Urology, Osaka, Japan.

出版信息

Int Braz J Urol. 2016 Sep-Oct;42(5):918-924. doi: 10.1590/S1677-5538.IBJU.2015.0607.

Abstract

PURPOSE

To evaluate the influence of prior abdominal surgery on the outcomes after robotic-assisted laparoscopic radical prostatectomy (RALP).

MATERIALS AND METHODS

We retrospectively analyzed patients with prostate cancer who underwent RALP between June 2012 and February 2015 at our institution. Patients with prior abdominal surgery were compared with those without prior surgery while considering the mean total operating, console, and port-insertion times; mean estimated blood loss; positive surgical margin rate; mean duration of catheterization; and rate of complications.

RESULTS

A total of 203 patients who underwent RALP during the study period were included in this study. In all, 65 patients (32%) had a prior history of abdominal surgery, whereas 138 patients (68%) had no prior history. The total operating, console, and port-insertion times were 328 and 308 (P=0.06), 252 and 242 (P=0.28), and 22 and 17 minutes (P=0.01), respectively, for patients with prior and no prior surgery. The estimated blood losses, positive surgical margin rates, mean durations of catheterization, and complication rates were 197 and 170 mL (P=0.29), 26.2% and 20.2% (P=0.32), 7.1 and 6.8 days (P=0.74), and 12.3% and 8.7% (P=0.42), respectively. Furthermore, whether prior abdominal surgery was performed above or below the umbilicus or whether single or multiple surgeries were performed did not further affect the perioperative outcomes.

CONCLUSIONS

Our results suggest that RALP can be performed safely in patients with prior abdominal surgery, without increasing the risk of complications.

摘要

目的

评估既往腹部手术对机器人辅助腹腔镜根治性前列腺切除术(RALP)术后结局的影响。

材料与方法

我们回顾性分析了2012年6月至2015年2月在本机构接受RALP的前列腺癌患者。将有既往腹部手术史的患者与无既往手术史的患者进行比较,同时考虑平均总手术时间、控制台操作时间和端口插入时间;平均估计失血量;手术切缘阳性率;平均导尿持续时间;以及并发症发生率。

结果

本研究纳入了研究期间接受RALP的203例患者。其中,65例患者(32%)有既往腹部手术史,而138例患者(68%)无既往手术史。有既往手术史和无既往手术史的患者,总手术时间、控制台操作时间和端口插入时间分别为328分钟和308分钟(P = 0.06)、252分钟和242分钟(P = 0.28)、22分钟和17分钟(P = 0.01)。估计失血量、手术切缘阳性率、平均导尿持续时间和并发症发生率分别为197毫升和170毫升(P = 0.29)、26.2%和20.2%(P = 0.32)、7.1天和6.8天(P = 0.74)、12.3%和8.7%(P = 0.42)。此外,既往腹部手术是在脐上还是脐下进行,或者是进行了单次还是多次手术,均未进一步影响围手术期结局。

结论

我们的结果表明,既往有腹部手术史的患者可以安全地进行RALP,而不会增加并发症风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0afa/5066887/627748b22692/1677-5538-ibju-42-05-0918-gf01.jpg

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