Boğa Mehmet Salih, Özsoy Çağatay, Aktaş Yasin, Aydın Arif, Savaş Murat, Ateş Mutlu
Department of Urology, Health Sciences University, Antalya Training and Research Hospital, Antalya, Turkey.
Department of Urology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey.
Turk J Urol. 2020 Mar 14;46(4):288-96. doi: 10.5152/tud.2020.19265.
To report the outcomes of robot-assisted radical cystectomy (RARC) and extended pelvic lymph node dissection (ePLND) series for bladder cancer.
Between October 2016 and June 2019, overall 57 patients (50 men, 7 women) were included in the study. Patient demographics, operative data, and postoperative pathological outcomes were evaluated. Patients who had a history of pelvic or Professional surgery due to other concurrent malignancy, radiation therapy, or lacked data were excluded from the study.
The mean age of the patients was 64.72±9.09 years. The mean operation time, intraoperative estimated blood loss, and hospitalization time were 418.58±85.66 minutes, 313.00±79.16mL, and 13.44±5.25 days, respectively. The postoperative pathological stages were reported as pT0 (n=8), pTis (n=4), pT1 (n=4), pT2 (n=22), pT3a (n=11), pT3b (n=2), pT4a (n=4), pT4b (n=1), and other (n=1). The mean lymph node (LN) yield was 23.45±9.43. Positive LNs were found in 16 (28.1%) patients. Surgical margins were positive in 3 (5.26%) patients. The mean follow-up period was 15.42±8.31 months. According to the modified Clavien-Dindo system, minor (Clavien 1-2) and major (Clavien 3-5) complications occurred in 18 (31.58%) and 9 (15.78%) patients during the early (0-30 days) period and in 4 (7.02%) and 5 (8.77%) patients in the late (31-90 days) period.
RARC and ePLND are complex but safe procedures with acceptable morbidity and excellent surgical and oncologic outcomes in muscle-invasive or high-risk bladder tumors.
报告机器人辅助根治性膀胱切除术(RARC)及扩大盆腔淋巴结清扫术(ePLND)治疗膀胱癌的系列研究结果。
2016年10月至2019年6月,本研究共纳入57例患者(50例男性,7例女性)。评估患者的人口统计学资料、手术数据及术后病理结果。有盆腔手术史或因其他并发恶性肿瘤接受过专业手术、放疗或缺乏相关数据的患者被排除在研究之外。
患者的平均年龄为64.72±9.09岁。平均手术时间、术中估计失血量及住院时间分别为418.58±85.66分钟、313.00±79.16毫升和13.44±5.25天。术后病理分期报告为pT0(n = 8)、pTis(n = 4)、pT1(n = 4)、pT2(n = 22)、pT3a(n = 11)、pT3b(n = 2)、pT4a(n = 4)、pT4b(n = 1)及其他(n = 1)。平均淋巴结收获数为23.45±9.43。16例(28.1%)患者发现阳性淋巴结。3例(5.26%)患者手术切缘阳性。平均随访时间为15.42±8.31个月。根据改良Clavien-Dindo系统,早期(0 - 30天)18例(31.58%)和9例(15.78%)患者发生轻微(Clavien 1 - 2级)和严重(Clavien 3 - 5级)并发症,晚期(31 - 90天)分别有4例(7.02%)和5例(8.77%)患者发生。
RARC及ePLND是复杂但安全的手术,对于肌层浸润性或高危膀胱肿瘤,其发病率可接受,手术及肿瘤学效果良好。