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门诊机器人辅助腹腔镜前列腺切除术:是否已准备好投入使用?一项生活质量分析。

Ambulatory Robot-Assisted Laparoscopic Prostatectomy: Is It Ready for Prime Time? A Quality of Life Analysis.

机构信息

Department of Urology, Larkin Hospital, Miami, Florida.

Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York.

出版信息

J Endourol. 2019 Oct;33(10):814-822. doi: 10.1089/end.2019.0261. Epub 2019 Aug 7.

Abstract

To investigate the difference, if any, in the quality of life (QoL) at specified intervals in patients undergoing same day discharge (SDD, ambulatory) next day discharge (NDD) after robot-assisted laparoscopic prostatectomy (RALP). Two hundred consecutive patients underwent RALP with either SDD or NDD. They completed validated pain and health-related QoL questionnaires at predefined intervals postoperatively and results were compared between the two groups. Pearson's coefficient revealed significant correlations between the time of discharge and physical well-being ( = -0.139;  = 0.005), emotional well-being (EWB) ( = -0.71;  < 0.001), functional assessment of cancer therapy-general (FACT-G) ( = -0.367;  < 0.001), functional assessment of cancer therapy-prostate (FACT-P) ( = -0.273;  < 0.001), pain severity score (PSS) ( = 0.237;  < 0.001), and pain interference score (PIS) ( = 0.214;  < 0.001). Student's -test revealed significant ( < 0.001) difference in the means of PSS, PIS, EWB, FACT-G, and FACT-P between both groups. Time of discharge was found to be an independent significant predictor ( < 0.01) of PSS and PIS. Pearson's coefficients revealed that PSS had significant correlations with age ( = -0.60;  < 0.001), body mass index ( = 0.87;  < 0.001), and console time (CT) ( = 0.63;  < 0.001). CT also correlated with the estimated blood loss ( = 0.65;  < 0.001). Patients who were discharged the same day as their RALP had lesser pain and interference in general activity scores 2 days after discharge and had better perceived overall health than patients who were discharged on postoperative day 1.

摘要

调查行机器人辅助腹腔镜前列腺切除术(RALP)后当日出院(SDD,门诊)和次日出院(NDD)患者在特定时间间隔的生活质量(QoL)是否存在差异。200 例连续接受 RALP 的患者被分为 SDD 或 NDD 组。他们在术后规定的时间间隔内完成了经过验证的疼痛和与健康相关的 QoL 问卷,并比较了两组之间的结果。Pearson 系数显示,出院时间与身体幸福感( = -0.139; = 0.005)、情感幸福感(EWB)( = -0.71; < 0.001)、癌症治疗一般功能评估量表(FACT-G)( = -0.367; < 0.001)、前列腺癌治疗功能评估量表(FACT-P)( = -0.273; < 0.001)、疼痛严重程度评分(PSS)( = 0.237; < 0.001)和疼痛干扰评分(PIS)( = 0.214; < 0.001)显著相关。Student's -test 显示两组之间 PSS、PIS、EWB、FACT-G 和 FACT-P 的平均值存在显著差异( < 0.001)。出院时间是 PSS 和 PIS 的独立显著预测因子( < 0.01)。Pearson 系数显示,PSS 与年龄( = -0.60; < 0.001)、体重指数( = 0.87; < 0.001)和控制台时间(CT)( = 0.63; < 0.001)显著相关。CT 还与估计失血量( = 0.65; < 0.001)相关。与术后第 1 天出院的患者相比,当天出院的患者在术后第 2 天的疼痛和对一般活动评分的干扰较小,整体健康状况较好。

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