BJU international · 2025
Stapled vs totally handsewn robotic intracorporeal neobladder: perioperative and functional outcomes.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mastroianni Riccardo, Chiacchio Giuseppe, Tuderti Gabriele, Brassetti Aldo, Anceschi Umberto, Ferriero Mariaconsiglia, Misuraca Leonardo, D'annunzio Simone, Bove Alfredo Maria, Anselmi Marianna, Guaglianone Salvatore, Flammia Rocco Simone, Proietti Flavia, Leonardo Costantino, Simone Giuseppe
Аннотация
OBJECTIVES: To compare perioperative, postoperative and functional outcomes between stapled (ST) and handsewn (HS) intracorporeal orthotopic neobladder (iON) configuration during robot-assisted radical cystectomy (RARC).
PATIENTS AND METHODS: Our single centre institutional bladder cancer dataset was queried for 'RARC' 'stapled' and 'handsewn' iON. Baseline, peri- and postoperative features of patients treated between January 2018 and July 2023 were collected. Continuous and categorical variables were compared using Kruskal-Wallis and chi-square tests. The Kaplan-Meier method was applied to assess functional outcomes. Cox regression analysis was performed to identify predictors of continence recovery.
RESULTS: Overall, 116 patients were enrolled (HS-iON, 60 patients). There were no differences in perioperative outcomes, except for the hospital length of stay, being shorter in the HS-iON cohort (P < 0.001). There were no differences in the 30- (P = 0.17) and 90-day (P = 0.69) postoperative complications. The stone rate was lower in the HS-iON cohort (P = 0.01). At Kaplan-Meier analysis, patients with HS-iON had higher day- (P < 0.001) and night-time (P < 0.001) continence recovery probabilities. At multivariable analysis, the only independent predictor of continence recovery was 'sex-sparing approach'. Excluding patients who underwent sex-sparing procedures, the HS approach was the only predictor of night-time continence recovery (hazard ratio 2.6, 95% confidence 1.27-5.34; P = 0.009).
CONCLUSION: Hand sewing may represent a preferable option for iON configuration during RARC. ST-iON did not prove to either reduce operative times or perioperative complications, while seemed to significantly impact on the risk of stone formation and continence recovery. Whenever oncologically feasible, a sex-sparing approach should be preferred to improve day- and night-time continence recovery.
PATIENTS AND METHODS: Our single centre institutional bladder cancer dataset was queried for 'RARC' 'stapled' and 'handsewn' iON. Baseline, peri- and postoperative features of patients treated between January 2018 and July 2023 were collected. Continuous and categorical variables were compared using Kruskal-Wallis and chi-square tests. The Kaplan-Meier method was applied to assess functional outcomes. Cox regression analysis was performed to identify predictors of continence recovery.
RESULTS: Overall, 116 patients were enrolled (HS-iON, 60 patients). There were no differences in perioperative outcomes, except for the hospital length of stay, being shorter in the HS-iON cohort (P < 0.001). There were no differences in the 30- (P = 0.17) and 90-day (P = 0.69) postoperative complications. The stone rate was lower in the HS-iON cohort (P = 0.01). At Kaplan-Meier analysis, patients with HS-iON had higher day- (P < 0.001) and night-time (P < 0.001) continence recovery probabilities. At multivariable analysis, the only independent predictor of continence recovery was 'sex-sparing approach'. Excluding patients who underwent sex-sparing procedures, the HS approach was the only predictor of night-time continence recovery (hazard ratio 2.6, 95% confidence 1.27-5.34; P = 0.009).
CONCLUSION: Hand sewing may represent a preferable option for iON configuration during RARC. ST-iON did not prove to either reduce operative times or perioperative complications, while seemed to significantly impact on the risk of stone formation and continence recovery. Whenever oncologically feasible, a sex-sparing approach should be preferred to improve day- and night-time continence recovery.