近年中國醫藥大學附設醫院泌尿科機器手臂輔助手術術後相關併發症
周聖峰、蕭博任、吳錫金、張兆祥、楊啟瑞、葉進仲、黃志平、陳冠亨
中國醫藥大學附設醫院泌尿部
Post-operative complications after robot-assisted urological surgeries in a tertiary referral center as CMUH
Sheng-Feng Chou1, Po-Jen Hsiao1, Hsi-Chin Wu1,2, Chao-Hsiang Chang1, Chi-Rei Yang1,
Chin-Chung Yeh1, Chi-Ping Huang1, Kuan-Heng Chen1
1Department of Urology, China Medical University Hospital, Taichung, Taiwan
2Tainan Municipal An-Nan Hospital, Tainan, Taiwan
Purpose:
Robotic systems have been introduced to aid in minimally invasive surgical procedures in urology. China Medical University Hospital established the Da Vinci Si system in Feb 2012 and have much experience in robotic-assisted sugery. The aim of our study was to present our experience about robot-assisted laparoscopic prostatectomy and review the surgical complications in recent years.
Materials and Methods:
We retrospectively reviewed medical records of patients who underwent robot-assisted urological surgeries in CMUH as tertiary referral center from January 2014 to December 2016. These procedures were performed by seven surgeons, five of them had abundant experiences of laparoscopic radical prostatectomy (LRP) or open retropubic radical prostatectomy (RRP), while the other two had performed less than 10 cases of LRP or RRP. Total case number of robot-assisted urological surgeries is 427. Complications were collected and reported according to the Clavien system and discuss separately.
Results:
Total case number of robot-assisted urological surgeries is 427. Patient characteristics The overall complication rate was 18.5% in the 1st year, 16.2% in the 2nd year, and 13.6% in the 3rd year with total number of 68 cases. Complication rates from the highest rate is as following: fever(48.2%), post-operation blood transfusion(18.7%), ileus(11.4%), shock(7.65%), prolonged lymphatic leakage(7.44%), infection(5.18%), wound dehiscence(1.24%), bleeding need TAE(0.14%), and open conversion(0.07%).
Conclusion:
The robotic system can be applied to most urological surgeries with acceptable morbidities. It can also help surgeons bypass the steep learning curve of laparoscopic surgeries. There is a tendency of lower complication rate in CMUH in recent years, and most of them is Clavien-Dindo grade I.