机器人辅助腹腔镜下根治性全膀胱切除术后并发症及其危险因素分析

目的研究机器人辅助腹腔镜下根治性全膀胱切除术后早期并发症及相关危险因素。方法回顾性分析2014年1月至2018年8月我院收治的117例膀胱癌患者的临床资料,采集资料包括:患者基本信息、实验室检查结果、手术相关信息及术后并发症情况等。根据Clavien-Dindo评分系统判定术后早期并发症及其严重程度,分析术后并发症的危险因素,将P<0.1的变量纳入多因素分析。结果机器人辅助腹腔镜根治性全膀胱切除术后早期并发症发生率约为55.6%,常见的术后早期并发症为肠梗阻23例(19.7%),感染22例(18.8%)及淋巴漏15例(12.8%),其中82例(70.1%)行原位回肠代膀胱术,35例(29.9%)行双侧输尿管腹壁造口。手术时间长(95%CI 1.000~1.011,P=0.034)、吸烟(95%CI 1.151~9.970,P=0.027)、糖尿病(95%CI 1.109~14.437,P=0.034)及术前白蛋白水平低(95%CI 0.772~0.986,P=0.029)是并发症发生的独立危险因素。结论术前禁烟、补充白蛋白、注意控制血糖及缩短手术时间对预防机器人辅助根治性全膀胱切除术后并发症的发生有重要意义。

Early complications and related risk factors of robot-assisted radical cystectomy

ObjectiveTo explore the early complications and related risk factors after robot-assisted radical cystectomy. MethodsThe clinical data of 117 bladder cancer patients in our hospital from January 2014 to August 2018 were retrospectively analyzed, the patient information, the laboratory test results, the operation date and complications were gathered. Early postoperative complications and their severity were assessed according to the Clavien-Dindo scoring system analysis of risk factors of postoperative complications, P<0.1 variables were brought into multiple factors analysis. ResultThis study found that the rate of early complications after robot-assisted radical cystectomy were 55.6% approximately, common early postoperative complications included intestinal obstruction (23 cases, 19.7%), infection (22 cases, 18.8%) and lymphatic leakage (15 cases, 12.8%). The results suggested that the operation time (95%CI 1.000~1.011, P=0.034), smoking (95%CI 1.151~9.970, P=0.027), preoperative albumin levels (95%CI 0.772~0.986, P=0.029) and diabetes (95%CI 1.109~14.437, P=0.034) were independent risk factors for severe complications. ConclusionThe incidence of the complications of the robot-assisted radical cystectomy is related to smoking forbidden, albumin supplementary, shorten the operation time and glucose control.