Abstract：
OBJECTIVE: To assess the short-term functional outcomes and morbidity of robotic-assisted cystectomy (RAC) and intracorporeal urinary diversion (ICUD) in patients with lower urinary tract dysfunction (LUTD).
METHODS: All consecutive patients who underwent RAC+ICUD for LUTD in a tertiary hospital center, between July 2018 and May 2021 were retrospectively included. Medical records were systematically reviewed and patient, perioperative and postoperative data were collected. A good short-term functional outcome was defined by the combination of a satisfying urostomy equipment (absence of urine leakage and easy appliance of the urostomy bag), the absence of pelvicaliceal system dilatation on sonography, and the absence of renal function decrease at the 2months post-operative consultation. Intraoperative parameters and post-operative complications were collected to assess morbidity.
RESULTS: Thirty-five patients were included. Eight (22.8%) patients needed intraoperative conversion to laparotomy. Twenty-five patients (92,5%) met criteria for a good functional outcome 2months post-operatively. The median operative time was 346min (86.5-407.5). The median blood loss was 100mL (100-290) and 5 patients (18.5%) required blood transfusion. The median times to return of bowel function was 3 days (2-4) and the median length of hospital stay was 10 days (10-18). Peri-operative complications were reported in 16 patients (59.2%): 6 (22.2%) minor complications Clavien ≤ II and 10 (37%) major complications Clavien ≥ III. There was no significative decrease of the renal function (mean preoperative creatininemia of 61.2μmol/L (50.5-74.5) vs 64.5μmol/L (47-85.25) postoperatively) CONCLUSION: RAC+ICUD in LUTD can provide good short-term functional outcomes while limiting blood transfusion, time to return of bowel function and the length of hospital stay. These results should be confirmed by larger prospective study.
METHODS:
METHODS: All consecutive patients who underwent RAC+ICUD for LUTD in a tertiary hospital center, between July 2018 and May 2021 were retrospectively included. Medical records were systematically reviewed and patient, perioperative and postoperative data were collected. A good short-term functional outcome was defined by the combination of a satisfying urostomy equipment (absence of urine leakage and easy appliance of the urostomy bag), the absence of pelvicaliceal system dilatation on sonography, and the absence of renal function decrease at the 2months post-operative consultation. Intraoperative parameters and post-operative complications were collected to assess morbidity.
RESULTS: Thirty-five patients were included. Eight (22.8%) patients needed intraoperative conversion to laparotomy. Twenty-five patients (92,5%) met criteria for a good functional outcome 2months post-operatively. The median operative time was 346min (86.5-407.5). The median blood loss was 100mL (100-290) and 5 patients (18.5%) required blood transfusion. The median times to return of bowel function was 3 days (2-4) and the median length of hospital stay was 10 days (10-18). Peri-operative complications were reported in 16 patients (59.2%): 6 (22.2%) minor complications Clavien ≤ II and 10 (37%) major complications Clavien ≥ III. There was no significative decrease of the renal function (mean preoperative creatininemia of 61.2μmol/L (50.5-74.5) vs 64.5μmol/L (47-85.25) postoperatively) CONCLUSION: RAC+ICUD in LUTD can provide good short-term functional outcomes while limiting blood transfusion, time to return of bowel function and the length of hospital stay. These results should be confirmed by larger prospective study.
METHODS:
摘要：
目的：评估下尿路功能障碍（LUTD）患者的机器人辅助膀胱切除术（RAC）和体内尿流改道（ICUD）的短期功能结局和发病率。方法：所有在三级医院中心接受RAC+ICUD治疗LUTD的连续患者，回顾性纳入2018年7月至2021年5月间的研究.系统审查了医疗记录，患者，收集围手术期及术后资料。良好的短期功能结局是通过令人满意的尿路造口术设备（没有尿液泄漏和尿路造口袋的简单应用）的组合来定义的。在超声检查中没有骨盆系统扩张，并且在术后2个月咨询时肾功能缺失下降。收集术中参数和术后并发症以评估发病率。结果：共纳入35例患者。八名（22.8％）患者需要术中转换为剖腹手术。25例患者（92,5％）符合术后2个月良好功能结局的标准。中位手术时间为346min(86.5～407.5)。中位失血量为100mL(100-290),5例(18.5%)需要输血。肠功能恢复的中位时间为3天（2-4），住院的中位时间为10天（10-18）。据报道，围手术期并发症有16例（59.2％）：6例（22.2％）次要并发症Clavien≤II和10例（37％）主要并发症Clavien≥III。肾功能没有显着下降（术前平均肌酐血症为61.2µmol/L（50.5-74.5）vs术后64.5µmol/L（47-85.25））结论：LUTD中的RACICUD可以提供良好的短期功能结果，同时限制输血，肠道功能恢复的时间和住院时间。这些结果应该通过更大的前瞻性研究得到证实。
