Makita Noriyuki, Kubota Masashi, Murata Shiori, Suzuki Issei, Tohi Yoichiro, Sugino Yoshio, Inoue Koji, Kawakita Mutsushi
The Department of Urology, Kobe City Medical Center General Hospital.
Hinyokika Kiyo. 2020 Sep;66(9):283-287. doi: 10.14989/ActaUrolJap_66_9_283.
Sixty eight patients had robot-assisted radical prostatectomy (RARP) from January 2016 to April 2017 with estimated blood loss of less than 500 ml. We compared the postoperative complication rates and the length of hospital stay between 34 of these patients who had pelvic drain placement (PD group), and the remaining 34 patients who had no drain placement (ND group). The approach was intraperitoneal in 25 patients in each group. The PD and ND groups were comparable for age (69.5 vs 70 yrs, P=0.459), clinical Gleason Score (6/7/≧8) 2/17/15 vs 3/8/23 (P=0.077), clinical stage (1c/2/3) 3/25/6 vs 1/25/8 (p=0. 539), operative time (311 vs 309 min, P=0.868), and estimated blood loss (p=0.166). The PD group had significantly higher median PSA level than the ND group (8.01 vs 6.25 ng/ml, P=0.023). Incidence of 30- day overall complications in the PD group (35 events) was lower than that in the ND group (38 events). All complications were classified as Clavien Dindo grade I. The postoperative hospital stay was 8 days in the PD group and 7 days in the ND group, showing no prolongation in the ND group. Pelvic drainage may be omitted after RARP without increasing postoperative complications or prolonging the hospital stay.
2016年1月至2017年4月期间,68例患者接受了机器人辅助根治性前列腺切除术(RARP),估计失血量少于500毫升。我们比较了其中34例放置盆腔引流管的患者(PD组)与其余34例未放置引流管的患者(ND组)的术后并发症发生率和住院时间。每组各有25例患者采用腹膜内入路。PD组和ND组在年龄(69.5岁对70岁,P = 0.459)、临床Gleason评分(6/7/≥8)(2/17/15对3/8/23,P = 0.077)、临床分期(1c/2/3)(3/25/6对1/25/8,p = 0.539)、手术时间(311分钟对309分钟,P = 0.868)和估计失血量(p = 0.166)方面具有可比性。PD组的中位PSA水平显著高于ND组(8.01对6.25 ng/ml,P = 0.023)。PD组30天总体并发症的发生率(35例)低于ND组(38例)。所有并发症均分类为Clavien Dindo I级。PD组术后住院时间为8天,ND组为7天,ND组未出现延长。RARP术后可省略盆腔引流,而不增加术后并发症或延长住院时间。