Department of Surgery, Division of Transplantation and Advanced Hepatobiliary Surgery, University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT, 84132, USA.
J Robot Surg. 2021 Aug;15(4):511-518. doi: 10.1007/s11701-020-01137-9. Epub 2020 Aug 9.
Bilateral native nephrectomies are needed in ESRD patients with select indications in a pre-transplant setting. Yet, the perioperative morbidity is significant in this population. Herein we evaluate the efficacy and utility of r-SABN.
A total of 12 patients were consented at a single center. Of 12 patients, 3 patients did not meet study criteria and were excluded. Preoperative, perioperative, and postoperative data were prospectively collected from 9 patients from electronic health records and administered postoperative surveys. Patients were assessed at 30-180 days postoperatively for follow-up.
Mean operative time was 204.3 ± 59.7 min (142.0-314.0) and estimated blood loss during operation was 94.4 ± 87.3 ml (25.0-300.0). The mean length of hospital stay was 2 ± 0.7 days (1-3) for all patients. Total post-operative opioid usage was normalized to morphine dose equivalents (MDE) and calculated to be 56.1 ± 30.4 mg (30.8-101.8). Patients experienced a fourfold and tenfold respective increase in weekly structural and incidental physical activity from 30 to 180 days postoperatively. There were no procedure related intraoperative or postoperative complications reported in the cohort.
Overall, r-SABN afforded the patients low morbidity. Longitudinal studies are in progress to further assess the efficacy and outcome of this procedure. In a single-center study, we demonstrate r-SABN is viable and provides a novel tool for treatment of ESRD patients requiring this procedure.
在移植前的特定情况下，对于有选择适应证的终末期肾病（ESRD）患者，需要进行双侧原生肾切除术。然而，该人群的围手术期发病率较高。在此，我们评估了 r-SABN 的疗效和实用性。
在一个单中心，共同意了 12 名患者。在 12 名患者中，有 3 名患者不符合研究标准，被排除在外。从电子病历中前瞻性收集了 9 名患者的术前、围手术期和术后数据，并进行了术后问卷调查。患者在术后 30-180 天进行随访评估。
平均手术时间为 204.3±59.7 分钟（142.0-314.0），术中估计失血量为 94.4±87.3 毫升（25.0-300.0）。所有患者的平均住院时间为 2±0.7 天（1-3 天）。总术后阿片类药物用量以吗啡等效剂量（MDE）归一化，并计算为 56.1±30.4 毫克（30.8-101.8）。患者在术后 30-180 天的每周结构性和偶发性体力活动分别增加了四倍和十倍。该队列中未报告与手术相关的术中或术后并发症。
总体而言，r-SABN 使患者的发病率较低。正在进行纵向研究，以进一步评估该手术的疗效和结果。在单中心研究中，我们证明了 r-SABN 是可行的，为需要该手术的 ESRD 患者提供了一种新的治疗工具。
