PD4-3: The comparison of robot-assisted, laparoscopic and open method for benign ureteral stricture
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  • 2017-12-22,
  • 上傳者: TUA秘書處,
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使用機器手臂輔助、腹腔鏡及傳統開腹方式執行輸尿管狹窄重建手術的比較

戴盟哲1、盧星華1,2、魏子鈞1,2、范玉華1,2、林志杰1,2、林子平1,2、黃逸修1,2

鍾孝仁1,2、吳宏豪1,2、黃志賢1,2、張延驊1,2、林登龍1,2

台北榮民總醫院 泌尿部1;國立陽明大學醫學院 泌尿學科 書田泌尿科學研究中心2

The comparison of robot-assisted, laparoscopic and open method for benign ureteral stricture

Meng-Che Tai1, Shing-Hwa Lu1,2, Tzu-Chun Wei1,2, Yu-Hua Fan1,2, Chi-Cheh Lin1,2, Tzu-Ping Lin1,2, Eric Y.H. Huang1,2, Hsiao-Jen Chung1,2, William J.S. Huang1,2, Howard H.H. Wu1,2, Yen-Hwa Chang1,2, Alex T.L. Lin1,2

Department of Urology, Taipei Veterans General Hospital1, Department of Urology, School of Medicine and Shu-Tien Urological Institute, National Yang-Ming University, Taipei, Taiwan2

 

Purpose: There are different approaches for the repair of benign ureteral stricture. Traditionally, these procedures have been performed by open surgery. With development of technology, minimally invasive approaches have been performed widely. The purpose of this study is to compare the outcome, feasibility, and perioperative results of robot-assisted, laparoscopic and open surgery method.

Materials and Methods: We retrospectively collected ureteropelvic junction obstruction and ureteral stricture patients who received reconstruction surgery from January, 2006 to August, 2017. Statistical analyses were performed for patients’ characteristics, perioperative data and clinical outcomes.

Results: Totally 91 patients were enrolled for analysis. We categorized these patients into three groups according the operative approaches. Thirty three patients received reconstructive surgery by robot-assisted method (Group I), 26 patients by laparoscopic method (Group II) and 32 patients by open method (Group III). All the procedures were completed successfully without open conversion. Average estimated blood loss, total operative time and complication rate showed no significant difference. Mean post-operative days of hospitalization were 6.4 ± 3.1 for Group I, 5.2 ± 1.4 for Group II and 8.1 ± 3.4 for Group III (P=0.001). At a median follow-up of 17.8 months, recurrence rate was 15.2%, 23.1% and 21.9% in Group I, Group II and Group III, respectively (P=0.700). These patients received further interventions such as long-term percutaneous nephrostomy, long-term double-J stent placement and balloon dilatation.

Conclusions: In our analysis, minimally invasive approach for ureteral reconstruction surgery could minimize the post-operative hospital stay. There is a tendency of lower recurrent rate by robot-assisted method although it showed no significant difference in limited case numbers. Thus, we need to collect more cases to make the conclusions in the future.

 

 

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    2017-12-22 16:58:55
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