Nakamura Leah Y, Nunez Rafael N, Andrews Paul E, Ferrigni Robert G, Humphreys Mitchell R, Swanson Scott K, Wolter Christopher E, Castle Erik P
Department of Urology, Mayo Clinic Arizona, 5777 East Mayo Blvd, Phoenix, AZ, 85054, USA.
J Robot Surg. 2011 Sep;5(3):201-8. doi: 10.1007/s11701-011-0251-1. Epub 2011 Feb 5.
To determine whether men aged 70 years and older had more perioperative complications after robot-assisted radical prostatectomy (RARP) compared with younger patients, a retrospective review was performed on patients who underwent RARP between March 2004 and September 2009. Subjects were stratified according to age into four groups (age 30-49, 50-59, 60-69, and ≥70 years). American Society of Anesthesiologists (ASA) scores were obtained. Complication rates in the perioperative period, transfusion rates, and length of stay were compared. Complications were classified using the previously validated Clavien system. There were a total of 293 patients aged 70 years and older amongst the 1,223 total subjects. ASA comorbidity scores did vary significantly amongst the different age groups, and there was modest correlation noted between ASA and age. There was no statistically significant difference amongst complication rates in men aged 70 years and older (15%) compared with the other cohorts (P = 0.832). There was also no significant difference in transfusion rates (P = 0.170) or length of stay (P = 0.131). Patients with higher ASA scores (ASA 3-4) had more Clavien I-II complications compared with patients with ASA scores of 1-2 (15.5% versus 10.3%, P = 0.03). There was no difference in transfusion rates or length of stay between the ASA scores. There are no more complications in men aged 70 years and older compared with men <70 years of age undergoing robot-assisted radical prostatectomy. RARP is a safe treatment option to offer to the selected elderly patient.
为了确定70岁及以上男性在机器人辅助根治性前列腺切除术(RARP)后是否比年轻患者有更多围手术期并发症,对2004年3月至2009年9月期间接受RARP的患者进行了一项回顾性研究。根据年龄将受试者分为四组(30 - 49岁、50 - 59岁、60 - 69岁和≥70岁)。获取美国麻醉医师协会(ASA)评分。比较围手术期并发症发生率、输血率和住院时间。使用先前验证的Clavien系统对并发症进行分类。在1223名总受试者中,共有293名年龄在70岁及以上的患者。不同年龄组之间的ASA合并症评分确实有显著差异,并且在ASA与年龄之间发现了适度的相关性。70岁及以上男性的并发症发生率(15%)与其他队列相比无统计学显著差异(P = 0.832)。输血率(P = 0.170)或住院时间(P = 0.131)也无显著差异。与ASA评分为1 - 2的患者相比,ASA评分较高(ASA 3 - 4)的患者有更多Clavien I - II级并发症(15.5%对10.3%,P = 0.03)。ASA评分之间的输血率或住院时间没有差异。与年龄小于70岁接受机器人辅助根治性前列腺切除术的男性相比,70岁及以上男性没有更多并发症。RARP是为选定的老年患者提供的一种安全的治疗选择。