Bailey George C, Frank Igor, Tollefson Matthew K, Gettman Matthew T, Knoedler John J
Department of Urology, Mayo Clinic, 200 First Street Southwest, Rochester, MN, 55905, USA.
J Robot Surg. 2018 Jun;12(2):223-228. doi: 10.1007/s11701-017-0717-x. Epub 2017 Jun 10.
Reports of surgical outcomes after robotic partial cystectomy are limited. The objective of this study is to review surgical outcomes after robotic partial cystectomy at a large tertiary referral center and compare outcomes with patients undergoing open partial cystectomy. Patients undergoing robotic partial cystectomy between 2003 and 2014 were identified. Patients were matched 2:1 based on gender, age, and Charlson Comorbidity Score with patients undergoing open partial cystectomy during the same time period. Patient charts were reviewed for surgical outcomes. Conditional logistic regression adjusted for matching was used to compare outcomes. At our institution, 11 patients underwent robotic partial cystectomy between 2003 and 2014. Median operative time was significantly longer in the robotic group, 214 (IQR 93, 230) minutes, than the open group, 93 (IQR 58, 143) minutes (p = 0.01). There was no difference in median estimated blood loss (p = 0.1). No patient required transfusion. There were no intraoperative complications. Median hospital stay was significantly shorter in the robotic partial cystectomy group, 1 (IQR 1, 2) day, than the open partial cystectomy group, 2 (IQR 2, 4) days (p = 0.01). Median duration of catheterization and complications within 30 days of surgery were not statistically different between the two groups. Median follow-up was 15.5 (IQR 8.6, 19.7) months for the robotic partial cystectomy group and 40.7 (IQR 6.5, 69.4) months for the open partial cystectomy group. Robotic partial cystectomy is safe, effective, and is associated with minimal morbidity when performed in properly selected patients for benign and malignant indications. When compared with open partial cystectomy, robotic partial cystectomy is associated with a longer operative time, but results in a shorter postoperative hospital stay.
机器人辅助部分膀胱切除术后的手术结果报告有限。本研究的目的是回顾一家大型三级转诊中心机器人辅助部分膀胱切除术后的手术结果，并将结果与接受开放性部分膀胱切除术的患者进行比较。确定了2003年至2014年间接受机器人辅助部分膀胱切除术的患者。根据性别、年龄和Charlson合并症评分，将患者与同期接受开放性部分膀胱切除术的患者按2:1进行匹配。查阅患者病历以获取手术结果。采用经匹配调整的条件逻辑回归来比较结果。在我们机构，2003年至2014年间有11例患者接受了机器人辅助部分膀胱切除术。机器人组的中位手术时间明显长于开放组，分别为214（四分位间距93，230）分钟和93（四分位间距58，143）分钟（p = 0.01）。中位估计失血量无差异（p = 0.1）。无患者需要输血。无术中并发症。机器人辅助部分膀胱切除组的中位住院时间明显短于开放性部分膀胱切除组，分别为1（四分位间距1，2）天和2（四分位间距2，4）天（p = 0.01）。两组在术后30天内的中位导尿持续时间和并发症方面无统计学差异。机器人辅助部分膀胱切除组的中位随访时间为15.5（四分位间距8.6，19.7）个月，开放性部分膀胱切除组为40.7（四分位间距6.5，69.4）个月。机器人辅助部分膀胱切除术是安全、有效的，在为良性和恶性适应症选择合适的患者中进行时，发病率极低。与开放性部分膀胱切除术相比，机器人辅助部分膀胱切除术的手术时间更长，但术后住院时间更短。
