科研之友
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摘要
Purpose: To identify patients who would benefit from robot-assisted radical cystectomy (RARC), we report perioperative outcomes and complications. %26lt;br%26gt;Patients and Methods: We compared patients who underwent RARC to patients who underwent open cystectomy (OC) in our institution. Data included demographics, operative variables, and recovery. Complications were grouped into early (%26lt; 30 days), intermediate (31-90 days), and late (%26gt; 90 days). %26lt;br%26gt;Results: There were 58 patients in the RARC group and 84 patients in the OC group. The mean age was 66 +/- 1.2 years in the RARC v 67 +/- 1.2 in OC (p = 0.53) group. Women constituted 21% in the RARC and 30% in OC (p = 0.23) group. The mean American Society of Anesthesiologists scores were 2.9 for the RARC and 2.94 for OC (p = 0.5). The mean operative time for RARC was 7.8 +/- 1.5 hours v 6.6 +/- 1.25 hours for OC (p %26lt; 0.0001). Estimated blood loss was 276 +/- 48mL in RARC v 1522 +/- 369mL in OC (p %26lt; 0.0001). Positive margin rate was 7% in RARC v 8% in OC (p = 0.8). Early complications of any severity (Clavien scores) occurred in 43% in RARC and 64% in OC (p = 0.02). There was one mortality in RARC and two mortalities in OC. Patients were grouped by age (%26gt;= 70- and %26lt; 70-years old). The older group consisted of 19 and 44 patients in RARC and OC, respectively. Both age groups in RARC had less early complications than OC patients (p %26lt; 0.014). The older group in RARC had less early complication rate (17%) than the younger group in OC (59%). %26lt;br%26gt;Conclusions: RARC has improved perioperative outcomes with equivalent oncological parameters when compared to open cystectomy. Patients %26gt;= 70-years old benefit from the robotic approach, particularly when compared to younger patients undergoing open cystectomy.
- 出版日期2013-1
