Eur Urol:前列腺癌盆腔照射后的机器人辅助膀胱切除术与体内尿路分流

2021-05-03 AlexYang MedSci原创

前列腺癌(PCa)的放射治疗(RT)因晚期泌尿系统副作用事件(UAEs)发生率高而造成使用负担。机器人辅助膀胱切除术(RAC)与体内尿路分流术(ICUD)治疗高等级泌尿副作用的可行性尚未评估。

前列腺癌(PCa)的放射治疗(RT)因晚期泌尿系统副作用事件(UAEs)发生率高而造成使用负担。机器人辅助膀胱切除术(RAC)与体内尿路分流术(ICUD)治疗高等级泌尿副作用的可行性尚未评估。

最近,有研究人员报道了RT后接受RAC治疗UAEs患者的围手术期结果、早期(≤90天)和晚期(>90天)的并发症情况

研究人员回顾性地评估了在一个三级中心接受RAC与ICUD治疗的32名患者。研究结果表明,年龄调整后的Charlson合并症指数(ACCI)中位数为6(IQR 5-7)。RAC后有29名患者(91%)为出血性放射性膀胱炎,2名患者(6.2%)膀胱收缩,1名患者出现(3.1%)尿瘘。评估出血量(EBL)、手术时间(OT)和住院时间(LOS)的中位数分别为250毫升、330分钟和10天。共有31名(97%)患者接受了回肠膀胱术。90天内Clavien-Dindo等级≥IIIa的并发症发生率为28%。晚期并发症发生率为46%,围手术期死亡率为0%。在单变量分析中,ACCI是唯一与早期并发症风险相关的参数(OR 1.75,95%CI 1.05-2.9;P=0.03)。随访的中位数为30个月(IQR 15-40)。缺乏与开放性膀胱切除术的比较是研究主要的限制。

早期和晚期术后并发症统计

最后,研究人员指出,对有盆腔照射史的患者进行UAEs的RAC,是高容量中心的一个可行选择。新技术的使用有助于克服一些技术困难,减少围手术期和后期并发症的风险。

原始出处:

Pietro Piazza, Giuseppe Rosiello, Victor Tames Chacon et al. Robot-assisted Cystectomy with Intracorporeal Urinary Diversion After Pelvic Irradiation for Prostate Cancer: Technique and Results from a Single High-volume Center. Eur Urol. Apr 2021

 

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    2021-05-04 misszhang

    前列腺癌相关研究,学习了,谢谢梅斯

    0

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