■回肠导管(IC)和原位新膀胱(ONB)在围手术期和术后结局和并发症方面的头对头比较,在机器人辅助根治性膀胱切除术(RARC)的特定设置中,不可用。
■为了解决尿流改道类型的影响(UD,ICvsONB)关于RARC发病率,以及手术时间(OT),停留时间(LOS)和再入院。
■确定了2008年至2020年在9个高容量欧洲机构接受RARC治疗的尿路上皮膀胱癌患者。
■带IC或ONB的RARC。
■根据《术中并发症评估与报告》和欧洲泌尿外科协会指南,收集并报告术中和术后并发症。分别。多变量逻辑回归模型测试了UD对结果的影响,在单一医院级别的聚类调整后。
■总的来说,确诊555例非转移性RARC患者。在280(51%)和275(49%)患者中,执行了IC和ONB,分别。记录18例术中并发症。术中并发症发生率在IC患者为4%,在ONB患者为3%(p=0.4)。在IC和ONB患者中,中位LOS和再入院率分别为10天和12天(p<0.001)和20%和21%(p=0.8)。分别。在多变量逻辑回归分析中,UD类型(ICvsONB)达到延长OT(比值比[OR]:0.61,p=0.03)和延长LOS(OR:0.34,p<0.001)的独立预测状态,但不适用于再入院(OR:0.92,p=0.7)。总的来说,324例患者出现513例术后并发症(58%)。160例(57%)IC患者与164例(60%)ONB患者(p=0.6)发生至少一次术后并发症。UD的类型达到了UD相关并发症的独立预测因子的状态(OR:0.64,p=0.03)。
■与带有ONB的RARC相比,RARC伴IC不易发生UD相关的术后并发症,延长OT,和延长的LOS。
■到目前为止,尿流改道类型的影响,即,回肠导管与原位新膀胱,机器人辅助根治性膀胱切除术的围手术期和术后结局未知.基于严格的数据应计,其依赖于已建立的并发症报告系统(术中并发症评估和报告通用标准和欧洲泌尿外科协会推荐系统),我们根据尿流改道类型报告术中和术后并发症。此外,我们发现回肠导管与较低的手术时间和住院时间有关,并在尿流改道相关并发症方面产生了保护作用。
UNASSIGNED: Head-to-head comparisons between ileal conduit (IC) and orthotopic neobladder (ONB) in terms of peri- and postoperative outcomes and complications, in the specific setting of robot-assisted radical cystectomy (RARC), are not available.
UNASSIGNED: To address the impact of the type of urinary diversion (UD, IC vs ONB) on RARC morbidity, as well as operative time (OT), length of stay (LOS), and readmissions.
UNASSIGNED: Urothelial bladder cancer patients treated with RARC at nine high-volume European institutions between 2008 and 2020 were identified.
UNASSIGNED: RARC with either IC or ONB.
UNASSIGNED: Intra- and postoperative complications were collected and reported according to the Intraoperative Complications Assessment and Reporting with Universal Standards recommendations and European Association of Urology guidelines, respectively. Multivariable logistic regression models tested the impact of UD on outcomes, after adjustment for clustering at single hospital level.
UNASSIGNED: Overall, 555 nonmetastatic RARC patients were identified. In 280 (51%) and 275 (49%) patients, an IC and an ONB were performed, respectively. Eighteen intraoperative complications were recorded. The rates of intraoperative complications were 4% in IC patients and 3% in ONB patients (p = 0.4). The median LOS and readmission rates were 10 versus 12 d (p < 0.001) and 20% versus 21% (p = 0.8) in IC versus ONB patients, respectively. At a multivariable logistic regression analyses, the type of UD (IC vs ONB) reached the independent predictor status for prolonged OT (odds ratio [OR]: 0.61, p = 0.03) and prolonged LOS (OR: 0.34, p < 0.001), but not for readmission (OR: 0.92, p = 0.7). Overall, 513 postoperative complications were experienced by 324 patients (58%). At least one postoperative complication was experienced by 160 (57%) IC patients versus 164 (60%) ONB patients (p = 0.6). The type of UD reached the status of an independent predictor of UD-related complications (OR: 0.64, p = 0.03).
UNASSIGNED: Compared with RARC with ONB, RARC with IC is less prone to UD-related postoperative complications, prolonged OT, and prolonged LOS.
UNASSIGNED: To date, the impact of the type of urinary diversion, namely, ileal conduit versus orthotopic neobladder, on peri- and postoperative outcomes of robot-assisted radical cystectomy is unknown. Based on a rigorous data accrual, which relied on established complication reporting systems (Intraoperative Complications Assessment and Reporting with Universal Standards and European Association of Urology recommended systems), we reported intra- and postoperative complications according to urinary diversion type. Moreover, we found that ileal conduit was associated with lower operative time and length of stay, and yielded a protective effect in terms of urinary diversion-related complications.