International Delphi consensus on single-port robotic radical prostatectomy: patient selection, surgical technique, and training.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Soputro Nicolas A, Rais-Bahrami Soroush, Bjurlin Marc, Srivastava Abhishek, Umbreit Eric, Eltemamy Mohamed, Pak Raymond, Gelikman David G, Hopson Nicholas, Geskin Albert, Mehrazin Reza, Vandyke Maia, Palese Michael, Nguyen Carvell, Ornstein David, Billah Mubashir Shabil, Russell Christopher, Yuh Bertram, Thong Alan, Olivares Ruben, Shetty Sugandh, Shakuri-Rad Jaschar, Baccala Angelo, Osinski Thomas, Simone Giuseppe, Crouzet Sebastien, Lee David I, Baker Mark, Ramadan Mohammad, Mattei Agostino, Porreca Angelo, Jafri Mohammad, Galfano Antonio, Link Richard E, Lam Po, Jones Marklyn, Bassett Jeffrey C, Musi Gennaro, Schwen Zeyad R, Beksac Alp Tuna, Eden Christopher, Miller Scott, Gontero Paolo, Amparore Daniele, Porpiglia Francesco, Vourganti Srinivas, Ahmed Mutahar, Montorsi Francesco, Perdona Sisto, Izzo Alessandro, Stifelman Michael D, Crivellaro Simone, Briganti Alberto, Kaouk Jihad, Autorino Riccardo
Аннотация
METHODS: A modified Delphi consensus was developed by a panel of experts, consisting of a 33-item questionnaire, with each statement rated using a binary Likert scale ('agree' or 'disagree'). The survey was distributed via email to all practicing SP-RARP surgeons across the USA and Europe. Consensus was defined as ≥75% agreement on a given statement.
RESULTS: A total of 53 surgeons participated in the Delphi Consensus across the two rounds. Of 33 statements, 28 (84.8%) reached agreement in the first round. The remaining consensus was achieved in the second round, involving 35 surgeons, and with one additional statement. The panel agreed that, although are no absolute contraindications to SP-RARP, the preference towards specific SP-RARP techniques should remain guided by the individual patients and surgical expertise. Although the SP extraperitoneal technique is recommended to pursue pelvic lymph node dissections, the panel agreed that transvesical SP-RARP showed promise in promoting shorter hospital stay, faster recovery of urinary continence, and utility in patients with extensive prior abdominal surgery. Consensus was also reached on the need for a structured training pathway, with most recommending beginning with extraperitoneal SP-RARP before advancing to the transvesical approach.
CONCLUSION: This Delphi consensus demonstrates broad agreement among experienced SP surgeons in the USA and Europe, forming the foundation for future research on the clinical utility and necessary training pathways for SP-RARP. Nevertheless, empirical validation based on clinical data from large cohort studies remains important.