Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Eur Urol Oncol. 2020 Dec;3(6):780-783. doi: 10.1016/j.euo.2020.04.003. Epub 2020 May 27.
The definition of intraoperative adverse events (IAEs) still lacks standardization, hampering the assessment of surgical performance in this regard. Over the years, efforts to address this issue have been carried out to improve the reporting of outcomes. In 2019, the European Association of Urology (EAU) proposed a standardized reporting tool for IAEs in urology. The objective of the present study is to distill systematically published data on IAEs in patients undergoing robotic partial nephrectomy (RPN) for renal masses to answer three key questions (KQs). (KQ1) Which system is used to report the IAEs? (KQ2) What is the frequency of IAEs? (KQ3) What types of IAEs are reported? A comprehensive systematic review of all English-language publications on RPN was carried out. We followed the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines to evaluate PubMed, Scopus, and Web of Science databases (from January 1, 2000 to January 1, 2019). Quality of reporting and grading complications were assessed according to the EAU recommendations. Globally, 59 (35.3%) and 108 (64.7%) studies reported zero and one or more IAEs, respectively. Overall, 761 (2.6%) patients reported at least one IAE. Intraoperative bleeding is reported as the most common IAE (58%). Our analysis showed no improvement in reporting and grading of IAEs over time. PATIENT SUMMARY: Up to now, an agreement regarding the definition and reporting of intraoperative adverse events (IAEs) in the literature has not been achieved. The aim of this study is to evaluate the reporting of IAEs in patients undergoing robotic partial nephrectomy (RPN) after a systematic review of the literature. More rigorous reporting of IAEs during RPN is needed to measure their impact on patients' perioperative care.
术中不良事件 (IAEs) 的定义仍缺乏标准化，这阻碍了对此类手术绩效的评估。多年来，为解决这一问题，人们一直致力于改进结果报告。2019 年，欧洲泌尿外科学会 (EAU) 提出了一种泌尿外科术中不良事件的标准化报告工具。本研究的目的是系统地总结发表的关于接受机器人辅助部分肾切除术 (RPN) 治疗肾肿瘤患者的术中不良事件数据，以回答三个关键问题 (KQs)。(KQ1) 用于报告 IAEs 的系统是什么？(KQ2) IAEs 的发生率是多少？(KQ3) 报告了哪些类型的 IAEs？对所有关于 RPN 的英语出版物进行了全面的系统综述。我们遵循系统评价和荟萃分析的首选报告项目 (PRISMA) 指南，评估了 PubMed、Scopus 和 Web of Science 数据库（从 2000 年 1 月 1 日至 2019 年 1 月 1 日）。根据 EAU 的建议评估报告质量和并发症分级。全球范围内，分别有 59 项（35.3%）和 108 项（64.7%）研究报告了零次和 1 次或多次 IAEs。总体而言，有 761 名（2.6%）患者报告至少发生了一次 IAE。术中出血被报道为最常见的 IAE（58%）。我们的分析表明，随着时间的推移，IAEs 的报告和分级没有改善。患者总结：到目前为止，文献中尚未就术中不良事件 (IAEs) 的定义和报告达成一致意见。本研究旨在通过对文献进行系统回顾，评估接受机器人辅助部分肾切除术 (RPN) 的患者的 IAE 报告情况。在 RPN 期间需要更严格地报告 IAEs，以衡量其对患者围手术期护理的影响。
