目的:报告我们将机器人前列腺癌根治术作为门诊手术的初步经验。
方法:回顾性分析2021年3月至2022年5月在我们中心接受RRP作为MAS(大型门诊手术)的患者。我们收集了基线患者特征,术中结果和术后数据(需要非计划的医疗护理和术后1个月的并发症).疾病诊断时的肿瘤特征(PSA,分期,ISUP,收集MRI)和术后病理结果。
结果:我们确定了总共35名患者,平均年龄为60,8±6,88岁,BMI为27±2,9Kg/m2。所有患者的麻醉风险都很低,并且25.71%的患者以前曾接受过腹部手术。手术时间为151,66±42,15min,平均失血量为301,2±184,38mL。2名病人(5.7%)入住一晚,7名病人(20%)在次月咨询急诊科,其中3人(8.57%)再次入院。我们记录了一次术中并发症,7例轻度术后并发症(ClavienI-II)和1例严重并发症(ClavienIIIb)。严重并发症发生在术后第8天,与门诊手术无关。
结论:术后即刻没有严重并发症,支持在MAS中RRP作为对选定患者的安全技术。
To report our initial experience with robotic radical prostatectomy as an outpatient procedure.
Retrospective analysis of patients who underwent RRP as MAS (Major Ambulatory Surgery) at our center between March 2021 and May 2022. We collected baseline patient characteristics, intraoperative outcomes and postoperative data (need for unplanned medical care and complications at one month after surgery). Oncologic characteristics at disease diagnosis (PSA, staging, ISUP, MRI) and postoperative pathologic outcomes were collected.
We identified a total of 35 patients with an average age of 60,8 ± 6,88 years and a BMI of 27 ± 2,9 Kg/m2. All patients had a low anesthetic risk and 25.71% had undergone previous abdominal surgery. The surgical time was 151,66 ± 42,15 min and the average blood loss was 301,2 ± 184,38 mL. Two patients (5.7%) were admitted for one night and 7 patients (20%) consulted the emergency department in the following month, of which 3 (8.57%) were readmitted. We recorded one intraoperative complication, seven mild postoperative complications (Clavien I-II) and one severe complication (Clavien IIIb). The severe complication occurred on the eighth postoperative day and was not related to the procedure being ambulatory.
The absence of serious complications in the immediate postoperative period supports RRP in MAS as a safe technique for selected patients.