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机器人辅助根治性前列腺切除术后第2天早期拔除导尿管:阿尔斯特技术的最新真实世界经验

Early Catheter Removal on Postoperative Day 2 After Robot-assisted Radical Prostatectomy: Updated Real-life Experience with the Aalst Technique.

作者信息

Develtere Dries, Rosiello Giuseppe, Piazza Pietro, Bravi Carlo Andrea, Pandey Abhishek, Berquin Camille, Sinatti Celine, Van Puyvelde Hannah, Puliatti Stefano, Amato Marco, Farinha Rui, Pauwels Elisabeth, De Groote Ruben, Schatteman Peter, De Naeyer Geert, D'Hondt Frederiek, Mottrie Alexandre

机构信息

Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Melle, Belgium.

Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium; ORSI Academy, Melle, Belgium; Department of Urology and Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.

出版信息

Eur Urol Focus. 2022 Jul;8(4):922-925. doi: 10.1016/j.euf.2021.10.003. Epub 2021 Oct 20.

Abstract

We evaluated the feasibility and impact on short- and long-term functional outcomes of very early catheter removal on postoperative day (POD) 2 after robot-assisted radical prostatectomy (RARP). To the best of our knowledge, this is the first multisurgeon study with the largest cohort on very early (POD 2) catheter removal after RARP with follow-up of >1 yr. In 255/369 patients (69%) treated with RARP ± pelvic lymph node dissection, the catheter was removed on POD 2. Among the 255 patients, 33 (13%) required recatheterisation because of acute urinary retention after catheter removal. Of these 33 patients, five (2%) also experienced anastomotic leakage after catheter removal. The early (≤3 mo) urinary continence rate was 67% and the median time to urinary continence recovery was 1 mo. After median follow-up of 18 mo (interquartile range 13-24), 236 patients (88%) were continent. No anastomotic strictures occurred. Our observations confirm the feasibility and safety of POD 2 catheter removal after RARP and support its adoption for selected patients. PATIENT SUMMARY: After removal of the prostate for cancer, patients have a urinary catheter inserted. We investigated whether earlier removal of the catheter affects long-term urinary continence. The results show that it may be safe to remove the catheter on postoperative day 2 for selected patients.

摘要

我们评估了机器人辅助根治性前列腺切除术(RARP)术后第2天(POD 2)极早期拔除导尿管的可行性及其对短期和长期功能结局的影响。据我们所知,这是第一项多外科医生参与、队列规模最大的关于RARP术后极早期(POD 2)拔除导尿管且随访时间超过1年的研究。在接受RARP±盆腔淋巴结清扫术治疗的369例患者中,255例(69%)在POD 2拔除了导尿管。在这255例患者中,33例(13%)因拔除导尿管后急性尿潴留而需要重新插导尿管。在这33例患者中,5例(2%)在拔除导尿管后还出现了吻合口漏。早期(≤3个月)尿失禁发生率为67%,尿失禁恢复的中位时间为1个月。中位随访18个月(四分位间距13 - 24个月)后,236例患者(88%)实现控尿。未发生吻合口狭窄。我们的观察结果证实了RARP术后POD 2拔除导尿管的可行性和安全性,并支持将其应用于特定患者。患者总结:前列腺癌患者切除前列腺后会插入导尿管。我们研究了更早拔除导尿管是否会影响长期尿失禁情况。结果表明,对于特定患者,术后第2天拔除导尿管可能是安全的。

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