To compare the feasibility and effectiveness of gum chewing to promote gastrointestinal (GI) recovery and prevent postoperative ileus (POI) in patients who underwent robot-assisted partial nephrectomy (RALPN), all subjects who met the enrollment criteria were randomly divided into the CG group (n = 23) and the control group (n = 29). No intervention other than chewing gum had been set between the two groups. We took the time of first bowel sound, exhaust, defecation, liquid diet, and solid diet as the study endpoints, and performed statistical analysis between the two groups. Baseline and postoperative data of patients were also recorded and analyzed. The time of first flatus, the first defecation, hospital stay, first liquid diet, and first solid diet in the chewing gum group were significantly shorter than those in the control group (all P < 0.05). CG can be an effective approach to promote bowel function recovery and prevent POI after robot-assisted partial nephrectomy.
Background
Several groups proved kidney‐sparing surgery (KSS) had equivalent oncological outcomes compared with radical nephroureterectomy (RNU) for the low‐risk upper urinary tract urothelial carcinoma (UTUC) patients. Whereas, the clinical efficacy of KSS for high‐risk UTUC, especially for distal high‐risk ureteral carcinoma, remains unclear.
Objective
To evaluate the feasibility of KSS for patients with distal high‐risk ureter cancer.
Materials and methods
Our study included 22 patients who diagnose the distal high‐risk ureter cancer and underwent KSS between May 2012 and July 2021 in the First Affiliated Hospital of Chongqing Medical University. Overall survival (OS), confirmed as the primary endpoint of present study, was assessed by a blinded independent review committee (BIRC). The secondary endpoints included the postoperative SF‐36 (the short form 36 health survey questionnaire) score, progression‐free survival (PFS), postoperative complications, and so on.
Results
Overall, 17 (77.3%) and 5 (22.7%) patients underwent segmental ureterectomy (SU) and endoscopic ablation (EA), respectively. By the cut‐off date, the mean OS was 76.3 months (95% Cl: 51.3–101.1 months) and the mean PFS was 47.0 months (95% Cl: 31.1–62.8 months), respectively. And the SF‐36 score in a majority of patients was >300 (90.9%).
Conclusion
This is a daring endeavor to explore the clinical efficacy of KSS in distal high‐risk ureter cancer based on the high‐risk UTUC criteria, which shows satisfactory results in the long‐term prognosis and operation‐associated outcomes. However, future randomized or prospective multicenter studies are necessary to validate our conclusions.
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