当前位置： SCI文献检索 > EUROPEAN UROLOGY期刊下所有文献 > Best practices in robot-assisted radical cystectomy and urinary reconstruction: recommendations of the Pasadena Consensus Panel.

Best practices in robot-assisted radical cystectomy and urinary reconstruction: recommendations of the Pasadena Consensus Panel.

Abstract：

CONTEXT:Robot-assisted surgery is increasingly used for radical cystectomy (RC) and urinary reconstruction. Sufficient data have accumulated to allow evidence-based consensus on key issues such as perioperative management, comparative effectiveness on surgical complications, and oncologic short- to midterm outcomes. OBJECTIVE:A 2-d conference of experts on RC and urinary reconstruction was organized in Pasadena, California, and the City of Hope Cancer Center in Duarte, California, to systematically review existing peer-reviewed literature on robot-assisted RC (RARC), extended lymphadenectomy, and urinary reconstruction. No commercial support was obtained for the conference. EVIDENCE ACQUISITION:A systematic review of the literature was performed in agreement with the PRISMA statement. EVIDENCE SYNTHESIS:Systematic literature reviews and individual presentations were discussed, and consensus on all key issues was obtained. Most operative, intermediate-term oncologic, functional, and complication outcomes are similar between open RC (ORC) and RARC. RARC consistently results in less blood loss and a reduced need for transfusion during surgery. RARC generally requires longer operative time than ORC, particularly with intracorporeal reconstruction. Robotic assistance provides ergonomic value for surgeons. Surgeon experience and institutional volume strongly predict favorable outcomes for either open or robotic techniques. CONCLUSIONS:RARC appears to be similar to ORC in terms of operative, pathologic, intermediate-term oncologic, complication, and most functional outcomes. RARC consistently results in less blood loss and a reduced need for transfusion during surgery. RARC can be more expensive than ORC, although high procedural volume may attenuate this difference. PATIENT SUMMARY:Robot-assisted radical cystectomy (RARC) is an alternative to open surgery for patients with bladder cancer who require removal of their bladder and reconstruction of their urinary tract. RARC appears to be similar to open surgery for most important outcomes such as the rate of complications and intermediate-term cancer-specific survival. Although RARC has some ergonomic advantages for surgeons and may result in less blood loss during surgery, it is more time consuming and may be more expensive than open surgery.

journal_name

Eur Urol

journal_title

European urology

authors

Wilson TG,Guru K,Rosen RC,Wiklund P,Annerstedt M,Bochner BH,Chan KG,Montorsi F,Mottrie A,Murphy D,Novara G,Peabody JO,Palou Redorta J,Skinner EC,Thalmann G,Stenzl A,Yuh B,Catto J,Pasadena Consensus Panel.

doi

10.1016/j.eururo.2014.12.009

subject

Has Abstract

pub_date

2015-03-01 00:00:00

pages

363-75

issue

eissn

0302-2838

issn

1873-7560

pii

S0302-2838(14)01264-0

journal_volume

pub_type

共识发展会议,杂志文章,实务指引,评审

在线工具

Best practices in robot-assisted radical cystectomy and urinary reconstruction: recommendations of the Pasadena Consensus Panel.