PDF(Pubmed)
Abstract：
The study aimed to evaluate the impact of abdominal drain placement (vs. omission) on perioperative outcomes of robot-assisted partial nephrectomy (RAPN), focusing on complications, time to canalization, deambulation, and pain management. A prospectively-maintained institutional database was queried to get data of patients who underwent RAPN for renal masses between January 2018 and May 2023 at our Institution. Baseline, surgical, and postoperative data were collected. Retrieved patients were stratified based upon placement of abdominal drain (Y/N). Descriptive analyses comparing the two groups were conducted as appropriate.77 After adjusting for potential confounders, a logistic regression analysis was conducted to evaluate significant predictors of any grade and \"major\" complications. 342 patients were included: 192 patients in the \"drain group\" versus 150 patients in the \"no-drain\" group. Renal masses were larger (p < 0.001) and at higher complexity (RENAL score, p = 0.01), in the drain group. Procedures in the drain group had statistically significantly longer operative time, ischemia time, and higher blood loss (all p-values < 0.001). The urinary collecting system was more likely involved compared to the no-drain group (p = 0.01). At multivariate analysis, abdominal drainage was not a significant predictor of any grade (OR 0.79, 95%CI 0.33-1.87) and major postoperative complications (OR 3.62, 95%CI 0.53-9.68). Patients in the drain group experienced a statistically significantly higher hemoglobin drop (p < 0.01). Moreover, they exhibited statistically significant higher paracetamol consumption (p < 0.001) and need for additional opioids (p = 0.02). In summary, the study results suggest the safety of omitting drain placement and remark on the need for personalized decision-making, which considers patient and procedural factors.
摘要：
这项研究旨在评估腹腔引流放置的影响(vs.遗漏)对机器人辅助肾部分切除术(RAPN)围手术期结果的影响，关注并发症，时间到了，下床,和疼痛管理。查询了前瞻性维护的机构数据库，以获取在我们机构于2018年1月至2023年5月期间接受RAPN治疗肾脏肿块的患者的数据。基线,外科,收集术后数据。根据腹腔引流管的放置（Y/N）对检索到的患者进行分层。对两组进行适当的描述性分析。77在调整潜在的混杂因素后，我们进行了logistic回归分析,以评估任何级别和"主要"并发症的重要预测因子.包括342例患者：“引流组”192例，“无引流组”150例。肾脏肿块更大（p<0.001），复杂性更高（RENAL评分，p=0.01),在排水组中。引流组的手术时间明显更长，缺血时间,和更高的失血量（所有p值<0.001）。与无引流组相比，更可能涉及尿液收集系统（p=0.01）。在多变量分析中，腹腔引流不是任何级别(OR0.79,95CI0.33-1.87)和主要术后并发症(OR3.62,95CI0.53-9.68)的显著预测指标.引流组患者的血红蛋白下降有统计学意义（p<0.01）。此外，他们表现出统计学上显著较高的扑热息痛消费量(p<0.001)和需要额外阿片类药物(p=0.02).总之,研究结果表明，省略排水沟放置的安全性和对个性化决策的需求的评论，其中考虑了患者和程序因素。
