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单孔机器人辅助根治性前列腺切除术的并发症:来自单孔高级研究联盟 (SPARC) 的多机构分析。

Complications of single-port robot-assisted radical prostatectomy: multi-institutional analysis from the Single-Port Advanced Research Consortium (SPARC).

机构信息

Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.

University of Illinois at Chicago (UIC), Chicago, IL, USA.

出版信息

BJU Int. 2024 Jul;134(1):54-62. doi: 10.1111/bju.16228. Epub 2023 Dec 3.

Abstract

OBJECTIVE

To evaluate the perioperative complications of single-port robot-assisted radical prostatectomy (SP-RARP).

PATIENTS AND METHODS

A retrospective review was performed on the prospectively maintained, Institutional Review Board-approved, multi-institutional Single-Port Advanced Research Consortium (SPARC) database. A total of 1103 patients were identified who underwent three different approaches of SP-RARP between 2019 and 2022 using the purpose-built SP robotic platform. In addition to baseline clinical, perioperative outcomes, this study comprehensively analysed for any evidence of intraoperative complication, as well as postoperative complication and readmission within 90 days of the respective surgery.

RESULTS

Of the 244, 712, and 147 patients who underwent transperitoneal, extraperitoneal, and transvesical SP-RARP, respectively, intraoperative complications were noted in five patients (0.4%), all of which occurred during the transperitoneal approach. Two patients had bowel serosal tears, two had posterior button-holing of the bladder necessitating repair, and one patient had an obturator nerve injury. Postoperative complications were noted in 143 patients (13%) with major complications (Clavien-Dindo Grade ≥III) only identified in 3.7% of the total cohort. The most common complications were lymphocele (3.9%), acute urinary retention (2%), and urinary tract infection (1.9%). The 90-day re-admission rate was 3.9%.

CONCLUSION

The SP-RARP is a safe and effective procedure with low complication and readmission rates regardless of the approach. These results are comparable to current multi-port RARP literature.

摘要

目的

评估单孔机器人辅助根治性前列腺切除术(SP-RARP)的围手术期并发症。

患者与方法

对机构审查委员会批准的、多机构单孔高级研究联盟(SPARC)前瞻性维护的数据库进行了回顾性分析。共确定了 1103 名患者,他们在 2019 年至 2022 年期间使用专用的 SP 机器人平台接受了三种不同方法的 SP-RARP。除了基线临床和围手术期结果外,本研究还全面分析了术中并发症、术后 90 天内的并发症和再入院的任何证据。

结果

在接受经腹腔、经腹膜外和经膀胱 SP-RARP 的 244、712 和 147 名患者中,分别有 5 名(0.4%)患者发生术中并发症,均发生在经腹腔途径。2 名患者肠浆膜撕裂,2 名患者膀胱后扣锁需要修复,1 名患者闭孔神经损伤。143 名(13%)患者发生术后并发症,仅 3.7%的总队列中出现主要并发症(Clavien-Dindo 分级≥III 级)。最常见的并发症是淋巴囊肿(3.9%)、急性尿潴留(2%)和尿路感染(1.9%)。90 天再入院率为 3.9%。

结论

SP-RARP 是一种安全有效的手术,并发症和再入院率低,无论采用哪种方法。这些结果与当前多端口 RARP 文献相当。

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