کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6193911 1259331 2016 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Benefits of robotic cystectomy with intracorporeal diversion for patients with low cardiorespiratory fitness: A prospective cohort study
ترجمه فارسی عنوان
مزایای سیستکتومی روبوتیک با انحراف درون کروی برای بیماران با تناسب اندام تنفسی قلبی: یک مطالعه کوهورت آینده نگر
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی تومور شناسی
چکیده انگلیسی


- Radical cystectomy patients have reduced cardiorespiratory fitness (CRF).
- Poor CRF predicts adverse outcomes in open radical cystectomy.
- CRF was measured before robotic cystectomy and intracorporeal diversion.
- Poor CRF did not predict increased Length of stay or major complications.
- Minimally invasive surgery minimizes stress response to surgery.

BackgroundPatients undergoing radical cystectomy have associated comorbidities resulting in reduced cardiorespiratory fitness. Preoperative cardiopulmonary exercise testing (CPET) measures including anaerobic threshold (AT) can predict major adverse events (MAE) and hospital length of stay (LOS) for patients undergoing open and robotic cystectomy with extracorporeal diversion. Our objective was to determine the relationship between CPET measures and outcome in patients undergoing robotic radical cystectomy and intracorporeal diversion (intracorporeal robotic assisted radical cystectomy [iRARC]).MethodsA single institution prospective cohort study in patients undergoing iRARC for muscle invasive and high-grade bladder cancer. Inclusion: patients undergoing standardised CPET before iRARC. Exclusions: patients not consenting to data collection. Data on CPET measures (AT, ventilatory equivalent for carbon dioxide [VE/VCO2] at AT, peak oxygen uptake [VO2]), and patient demographics prospectively collected. Outcome measurements included hospital LOS; 30-day MAE and 90-day mortality data, which were prospectively recorded. Descriptive and regression analyses were used to assess whether CPET measures were associated with or predicted outcomes.ResultsFrom June 2011 to March 2015, 128 patients underwent radical cystectomy (open cystectomy, n = 17; iRARC, n = 111). A total of 82 patients who underwent iRARC and CPET and consented to participation were included. Median (interquartile range): age = 65 (58-73); body mass index = 27 (23-30); AT = 10.0 (9-11), Peak VO2 = 15.0 (13-18.5), VE/VCO2 (AT) = 33.0 (30-38). 30-day MAE = 14/111 (12.6%): death = 2, multiorgan failure = 2, abscess = 2, gastrointestinal = 2, renal = 6; 90-day mortality = 3/111 (2.7%). AT, peak VO2, and VE/VCO2 (at AT) were not significant predictors of 30-day MAE or LOS. The results are limited by the absence of control group undergoing open surgery.ConclusionsPoor cardiorespiratory fitness does not predict increased hospital LOS or MAEs in patients undergoing iRARC. Overall, MAE and LOS comparable with other series.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Urologic Oncology: Seminars and Original Investigations - Volume 34, Issue 9, September 2016, Pages 417.e17-417.e23
نویسندگان
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