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关于微孔多糖微球有效性的真实世界数据,该有效性可使即使是新手外科医生也能安全地进行机器人辅助根治性前列腺切除术。

Real-World Data on the Effectiveness of Microporous Polysaccharide Hemospheres for Allowing Even Novice Surgeons to Perform Robot-Assisted Radical Prostatectomy Safely.

作者信息

Nirei Takuma, Tatenuma Tomoyuki, Muraoka Kentaro, Aomori Kota, Ito Yusuke, Hasumi Hisashi, Hayashi Narihiko, Nakaigawa Noboru, Makiyama Kazuhide

机构信息

Department of Urology, Yokohama City University Hospital, Fukuura, Kanazawa, Yokohama, Japan; Department of Urology, Fujisawa Shonandai Hospital, Takakura, Fujisawa, Kanagawa, Japan.

Department of Urology, Yokohama City University Hospital, Fukuura, Kanazawa, Yokohama, Japan.

出版信息

Urol Res Pract. 2023 Jul;49(4):241-245. doi: 10.5152/tud.2023.22242.

Abstract

OBJECTIVE

Radical prostatectomy can be performed more safely and with fewer com- plications since the advent of robot-assisted surgery. However, increased bleeding is a concern when robot-assisted radical prostatectomy includes lymph node dissection and nerve sparing. In real-world clinical practice, inexperienced surgeons sometimes perform robot-assisted radical prostatectomy. In this study, we investigated the effec- tiveness of microporous polysaccharide hemospheres as a local hemostatic agent in robot-assisted radical prostatectomy.

METHODS

We retrospectively evaluated 301 patients who underwent robot-assisted radical prostatectomy at our institution between December 2017 and November 2020. The patients were divided into 2 groups according to whether their surgery was per- formed after the introduction of microporous polysaccharide hemospheres as a local hemostatic agent (group A, n = 140) or before it (group B, n = 161: historical control).

RESULTS

Preoperative androgen deprivation therapy was significantly more common in group A than in group B (23 vs. 11, P = .009). Furthermore, surgeons were significantly less experienced (P < .001) and the operation time was significantly longer (260 min- utes vs. 229 minutes; P < .001) in group A than in group B. There was no significant difference in any other patient background characteristics or in the surgical outcomes between the groups.

CONCLUSION

The use of microporous polysaccharide hemospheres allowed even inex- perienced surgeons to perform robot-assisted radical prostatectomy without compro- mising surgical outcomes.

摘要

目的

自机器人辅助手术出现以来,根治性前列腺切除术可以更安全地进行,并发症也更少。然而,当机器人辅助根治性前列腺切除术包括淋巴结清扫和保留神经时,出血增加是一个令人担忧的问题。在实际临床实践中,经验不足的外科医生有时会进行机器人辅助根治性前列腺切除术。在本研究中,我们调查了微孔多糖微球作为局部止血剂在机器人辅助根治性前列腺切除术中的有效性。

方法

我们回顾性评估了2017年12月至2020年11月期间在我院接受机器人辅助根治性前列腺切除术的301例患者。根据手术是否在引入微孔多糖微球作为局部止血剂之后进行,将患者分为两组(A组,n = 140)或之前(B组,n = 161:历史对照组)。

结果

术前雄激素剥夺治疗在A组比在B组显著更常见(23例对11例,P = .009)。此外,A组外科医生的经验明显不足(P < .001),手术时间明显更长(260分钟对229分钟;P < .001)。两组之间在任何其他患者背景特征或手术结果方面均无显著差异。

结论

使用微孔多糖微球使即使是经验不足的外科医生也能进行机器人辅助根治性前列腺切除术,而不会影响手术结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d01/10544207/40de0450ed3f/urp-49-4-241_f001.jpg

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