Revisión sistemática de resultados perioperatorios y complicaciones después de cistectomía radical abierta, laparoscópica y asistida por robot

Palazzetti, Anna; Sánchez-Salas, Rafael; Capogrosso, Paolo; Barret, Éric; Cathala, Nathalie; Mombet, Annick; Prapotnich, Dominique; Galiano, Marc; Rozet, François; Cathelineau, Xavier

doi:10.1016/j.acuro.2016.05.009

Cited by 16 publications

(2 citation statements)

References 44 publications

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“…When compared to open surgery, laparoscopic and robotic ones lead to reduction of overall morbidity and better perioperative outcomes [32]. In addition, to obtain a better cosmetic result, MIS was proved to minimize intraoperative bleeding, to reduce postoperative pain, and to allow early mobilization; consequently, the minimally invasive strategy decreased the patient’s discomfort and the length of stay [33, 34, 35, 36, 37].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of surgical site infection in mini-invasive urological surgery

et al. 2019

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AbstractSurgical Site Infection (SSI) is the most frequent source of infection in surgical patients and the second most frequent cause of hospital-acquired infection. The primary aim of this prospective study was to compare SSI occurrences between minimally invasive surgery (MIS) and open urological surgery. Secondly, perioperative outcomes were evaluated in two different approaches.A consecutive group of 60 patients undergoing urological surgery were prospectively enrolled in a single high-volume center between May and October 2018. We included procedures that were performed by minimally invasive or traditional techniques. We evaluated and compared the incidence of SSI and perioperative outcomes in terms of intraoperative bleeding, post-operative complications, postoperative pain, patient satisfaction with the analgesic treatment, time to flatus, time of oral intake and mobilization, and length of hospital stay. The two groups were homogeneous with regard to demographic data.Superficial incisional SSIs were diagnosed in 10% of cases (3/30) in the second group and 0% in the first (p<0.05); space/organ SSIs developed in 4 patients, which were diagnosed by ultrasound scan and confirmed by abdominal CT: 1 patient (3.3%) in group 1 showed an infected lymphocele, whereas 1 case of infected lymphocele and 2 cases of pelvic abscess were detected in group 2 (10%, p<0.05). All the perioperative outcomes as well as were overall complication rate favored MIS (p<0.05). The use of minimally invasive techniques in urological surgery reduced the risk of SSI by comparison with a traditional approach. In addition, MIS was associated with better perioperative outcomes and a lower overall complication rate.

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Section: Discussionmentioning

confidence: 99%

Evaluation of surgical site infection in mini-invasive urological surgery

et al. 2019

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“…Radical cystectomy (RC) is the standard treatment of muscle‐invasive bladder cancer (BCa) 1‐3 . However, RC is an invasive procedure, which is associated with up to 85% overall complications and with up to 16.6% 90‐days mortality 4‐9 . In consequence, careful patient selection for RC is necessary, 10 especially in the elderly, to avoid high rates of other‐cause mortality (OCM) after RC that may cancel out the potential oncological benefits of this surgery 11 .…”

Section: Introductionmentioning

confidence: 99%

Rates of other‐cause mortality after radical cystectomy are decreasing over time—A population‐based analysis over two decades

Rosiello

Knipper

Palumbo

et al. 2020

Journal of Surgical Oncology

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Background and Objectives: To investigate other-cause mortality (OCM) rates over time according to several baseline characteristics in bladder cancer (BCa) patients treated with radical cystectomy (RC). Methods: Within the Surveillance, Epidemiology, and End Results database (1988-2011), we identified 7702 T 1-2 N 0 M 0 urothelial BCa patients treated with RC. Temporal trends and multivariable Cox regression (MCR) analyses assessed 5-year OCM. Data were stratified according to the year of diagnosis (), age group (<60 vs 60-75 vs >75 years), sex, race, marital status, and socioeconomic status. Results: Overall, OCM rates decreased from 13.9% in 1988-1995 to 8.6% in 2009-2011. The greatest decrease was recorded in elderly (>75) patients (32%-16%, slope: −0.55% per year; P = .01), followed by patients aged 60 to 75 (21%-5%, slope: −0.35% per year; P = .01), unmarried patients (16%-10%, slope: −0.26% per year; P < .001), male patients (14%-8.9%, slope: −0.23% per year), and African Americans (16%-11%, slope: −0.27% per year; P < .001). MCR models corroborated these results.Conclusions: Most important decrease in OCM after RC over the last decades was recorded in the elderly, unmarried, and male patients. Nonetheless, these three patient groups still represent ideal targets for efforts aimed at minimizing the morbidity and mortality after RC, as their risk of OCM is higher than in others. K E Y W O R D Sbladder cancer, competing risk, elderly, risk factors, SEER database

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Comparison of perioperative outcomes in robot‐assisted radical cystectomy and laparoscopic radical cystectomy

Zhang

Lin

Zhang

et al. 2020

Robotics Computer Surgery

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Objective To report perioperative outcomes in robot‐assisted radical cystectomy and laparoscopic radical cystectomy. Patients and Methods Between January 2010 and July 2019, 298 patients with bladder cancer underwent robotic‐assisted radical cystectomy (RARC) (n = 172) and laparoscopic radical cystectomy (LRC) (n = 126) at our institution were enrolled in the retrospective study. The demographic, perioperative, and complication data were collected and analyzed. Results The RARC group had less operative duration (P < .001), less blood loss (P < .001), lower transfusion rate (P < .05), and shorter hospital stay (P < .001) than the LRC group. The 90‐day readmission rate between the RARC and LRC group had no significant differences (P = .401). The 90‐day overall complication rates in the RARC group was much lower than the LRC group (P = .009). The 90‐day minor complication rates (Clavien‐Dindo grade ≤ IIA) between the RARC and LRC groups were similar (P = .274). The 90‐day major complication rates (Clavien‐Dindo grade ≥ IIIA) in the LRC group was higher than the RARC group (P = .022). Conclusions The RARC approach appears to offer some operative and perioperative benefits compared with the LRC approach. Larger, randomized studies are required to confirm these findings.

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Revisión sistemática de resultados perioperatorios y complicaciones después de cistectomía radical abierta, laparoscópica y asistida por robot

Cited by 16 publications

References 44 publications

Evaluation of surgical site infection in mini-invasive urological surgery

Evaluation of surgical site infection in mini-invasive urological surgery

Rates of other‐cause mortality after radical cystectomy are decreasing over time—A population‐based analysis over two decades

Comparison of perioperative outcomes in robot‐assisted radical cystectomy and laparoscopic radical cystectomy

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