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机器人辅助输尿管再植术:单中心对照研究。

Robot-Assisted Ureteral Reimplantation: A Single-Center Comparative Study.

机构信息

Division of Urology, VCU Health, Richmond, Virginia, USA.

Department of Urology, University of Bari, Bari, Italy.

出版信息

J Endourol. 2021 Oct;35(10):1504-1511. doi: 10.1089/end.2021.0083.

Abstract

Aim of this study was to report a single-center experience with robot-assisted ureteral reimplantation (RAUR) and to compare its outcomes with those of open ureteral reimplantation (OUR). Patients who underwent RAUR or OUR for ureteral disease between 2016 and 2020 were identified. Data collected included baseline, pathologic, perioperative, and postoperative features. The RAUR outcomes were compared with those of OUR. Overall, 21 (42.8%) patients underwent RAUR, and 28 (57.2%) underwent OUR. The two groups were similar in terms of baseline and pathologic characteristics. There was a statistically significant difference in favor of RAUR for median operative time (216 317 minutes,  = 0.01) and median blood loss (35 175 mL,  = 0.001). No difference was observed in overall complication rate (33.3% 46.4%,  = 0.9), as well as major complications (Clavien-Dindo≥III grade) rate between RAUR and OUR groups. Median length of stay was shorter for RAUR (2 6 days;  = 0.001), as well as median catheterization time (16 28 days;  = 0.005). RAUR is a safe and effective minimally invasive surgical procedure for the management of mid to distal ureteral strictures. It can recapitulate the success rate of the gold standard OUR while offering a benefit in terms of lower surgical morbidity and faster postoperative recovery.

摘要

本研究旨在报告单中心机器人辅助输尿管再植术(RAUR)的经验,并将其结果与开放输尿管再植术(OUR)进行比较。 确定了 2016 年至 2020 年间因输尿管疾病接受 RAUR 或 OUR 的患者。收集的数据包括基线、病理、围手术期和术后特征。比较了 RAUR 的结果与 OUR 的结果。 总体而言,21 例(42.8%)患者接受 RAUR,28 例(57.2%)患者接受 OUR。两组在基线和病理特征方面相似。RAUR 的中位手术时间(216 317 分钟,= 0.01)和中位出血量(35 175 毫升,= 0.001)具有统计学意义。两组的总并发症发生率(33.3% 46.4%,= 0.9)以及 RAUR 和 OUR 组的主要并发症(Clavien-Dindo≥III 级)发生率无差异。RAUR 的中位住院时间更短(2 6 天;= 0.001),中位导尿管时间更短(16 28 天;= 0.005)。 RAUR 是一种安全有效的微创手术,可用于治疗中下段输尿管狭窄。它可以复制金标准 OUR 的成功率,同时具有较低的手术发病率和更快的术后恢复优势。

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