Sighinolfi Maria Chiara, Calcagnile Tommaso, Panio Enrico, Assumma Simone, Sarchi Luca, Sandri Marco, Santangelo Emanuela, Petix Michele, Sangalli Mattia, Turri Filippo, Bozzini Giorgio, Moschovas Marcio Covas, Patel Vipul, Rocco Bernardo
Department of Urology, ASST Santi Paolo e Carlo, 20142 Milan, Italy.
Department of Data Methods and Statistics, University of Brescia, 25121 Brescia, Italy.
Clin Pract. 2024 Aug 31;14(5):1790-1800. doi: 10.3390/clinpract14050143.
Despite the advent of robotics and the decreasing rate of complications after radical cystectomy, several factors are renowned to impair the early outcomes of this procedure. The aim of this paper is to provide a multivariate analysis (MVA) of patient and surgical procedure-related variables likely to affect postoperative course and 30-day complication rate. Fifty-five robotic-assisted radical cystectomies (RARCs) performed at a single center from July 2021 to March 2023 were enrolled. Baseline demographics, comorbidities, and intraoperative and postoperative data were collected. Uni- and multivariate analyses were performed to evaluate the relationship with Clavien ≥ II complications arising within 30 days of surgery. A postoperative Clavien ≥ II complication was evident in 15 patients (28%), whereas Clavien ≥ III occurred only in 5 (9%). At MVA, the only independent predictor of Clavien ≥ II complications was a prior neoadjuvant chemotherapy (OR 5.6; 95% CI 1.22-25.3, = 0.026). Recognized the small sample size, patients who received a prior NAC should deserve special care within the postoperative course.
尽管机器人技术已经出现，且根治性膀胱切除术后并发症发生率不断降低，但仍有几个因素会影响该手术的早期效果。本文旨在对可能影响术后病程和30天并发症发生率的患者及手术相关变量进行多因素分析（MVA）。纳入了2021年7月至2023年3月在单一中心进行的55例机器人辅助根治性膀胱切除术（RARC）。收集了基线人口统计学资料、合并症以及术中及术后数据。进行单因素和多因素分析以评估与术后30天内发生的Clavien≥II级并发症的关系。15例患者（28%）出现术后Clavien≥II级并发症，而Clavien≥III级仅发生在5例（9%）。在多因素分析中，Clavien≥II级并发症的唯一独立预测因素是先前的新辅助化疗（OR 5.6；95%CI 1.22 - 25.3，P = 0.026）。鉴于样本量较小，接受过先前新辅助化疗的患者在术后病程中应得到特别护理。
