Predicting perioperative outcomes of robot-assisted radical cystectomy: Data from the Asian Robot-Assisted Radical Cystectomy Consortium

被引：7

作者：

Lee, Alvin Yuanming ^{[1
,2
]}

Allen, John Carson, Jr. ^{[3
]}

Teoh, Jeremy Yuen-Chun ^{[4
,5
]}

Kang, Seok-Ho ^{[6
]}

Patel, Manish, I ^{[7
,8
]}

Muto, Satoru ^{[9
]}

Yang, Cheng-Kuang ^{[10
]}

Hatakeyama, Shingo ^{[11
]}

Zhang, Ruiyun ^{[12
]}

Kijvikai, Kittinut ^{[13
]}

Chen, Haige ^{[12
]}

Ohyama, Chikara ^{[11
]}

Horie, Shigeo ^{[9
]}

Chan, Eddie Shu-Yin ^{[4
]}

Lee, Lui-Shiong ^{[1
,2
]}

机构：

[1] Sengkang Gen Hosp, Dept Urol, 110 Sengkang East Way, Singapore 544886, Singapore

[2] Singapore Gen Hosp, Dept Urol, Singapore, Singapore

[3] Duke NUS Grad Med Sch, Singapore, Singapore

[4] Chinese Univ Hong Kong, SH Ho Urol Ctr, Dept Surg, Hong Kong, Peoples R China

[5] European Assoc Urol Young Acad Urol, Urothelial Carcinoma Working Grp EAU YAU, Arnhem, Netherlands

[6] Korea Univ, Sch Med, Dept Urol, Seoul, South Korea

[7] Univ Sydney, Sydney Med Sch, Discipline Surg, Sydney, NSW, Australia

[8] Westmead Hosp, Dept Urol, Sydney, NSW, Australia

[9] Juntendo Univ, Grad Sch Med, Dept Urol, Tokyo, Japan

[10] Taichung Vet Gen Hosp, Dept Surg, Div Urol, Taichung, Taiwan

[11] Hirosaki Univ, Grad Sch Med, Dept Urol, Hirosaki, Aomori, Japan

[12] Shanghai Jiao Tong Univ, Sch Med, Renji Hosp, Dept Urol, Shanghai, Peoples R China

[13] Mahidol Univ, Ramathibodi Hosp, Fac Med, Div Urol,Dept Surg, Bangkok, Thailand

来源：

INTERNATIONAL JOURNAL OF UROLOGY | 2022年 / 29卷 / 09期

关键词：

bladder cancer; complications; perioperative outcomes; radical cystectomy; robotic surgery; INVASIVE BLADDER-CANCER; NEOADJUVANT CHEMOTHERAPY; COMPLICATIONS; ILEUS;

D O I：

10.1111/iju.14937

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives To report the perioperative outcomes of robot-assisted radical cystectomy and elucidate their risk factors. Methods A review of the Asian Robot-Assisted Radical Cystectomy Consortium database from 2007 to 2020 was performed. The perioperative outcomes studied included complication rates, time to solid food intake, estimated blood loss, length of hospital stay, and 30-day readmission rates. Results Of 568 patients, the overall complication rate was 49.2%, comprising major complications in 15.6%. Preoperative hydronephrosis was associated with an increased risk of major complications (odds ratio 3.27, 95% confidence interval 1.48-7.26, P = 0.004) while neoadjuvant chemotherapy was protective (odds ratio 0.46, 95% confidence interval 0.25-0.84, P = 0.012). The median time to solid food intake was 4 days (interquartile range 3-7) and smoking was a risk factor (odds ratio 4.28, 95% confidence interval 2.36-7.79, P < 0.001) for prolonged time to solid food intake. Median length of hospital stay was 13 days (interquartile range 9-19), and diabetes mellitus (odds ratio 1.66, 95% confidence interval 1.08-2.56, P = 0.021), neoadjuvant chemotherapy (odds ratio 2.21, 95% confidence interval 1.46-3.33, P < 0.001), and orthotopic bladder substitute creation (odds ratio 2.82, 95% confidence interval 1.90-4.18, P < 0.001) were independent risk factors for prolonged length of hospital stay. The 30-day readmission rate was 23.4% and higher in those with bilateral hydronephrosis (odds ratio 4.58, 95% confidence interval 1.97-10.65, P < 0.001) and orthotopic bladder substitute creation (odds ratio 1.87, 95% confidence interval 1.16-3.02, P = 0.010). Conclusions There are preoperative conditions which are significant risk factors for adverse perioperative outcomes in robot-assisted radical cystectomy. Most are potentially modifiable and can direct strategies to reduce surgical morbidity related to this major oncological procedure.

引用

页码：1002 / 1009

页数：8

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