与放置 SpaceOAR 水凝胶有关的并发症和围手术期影响因素。

IF 1.8 Q3 UROLOGY & NEPHROLOGY Advances in Urology Pub Date : 2024-09-03 eCollection Date: 2024-01-01 DOI:10.1155/2024/3439727
Kerith R Wang, Rishabh K Simhal, Cassra B Clark, Mark J Mann, James R Mark, Costas D Lallas, Robert Den, Edouard J Trabulsi
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引用次数: 0

摘要

摘要研究一家学术机构在放置SpaceOAR方面的经验、相关并发症以及影响疗效的围手术期特征,以达到提高质量的目的:我们对 2018 年至 2021 年期间接受四位外科医生和一位放射肿瘤科医生治疗的 233 名患者进行了回顾性研究。记录了人口统计学、肿瘤学参数、放射计划和水凝胶置入的放射学评估等变量。夏尔森合并症指数(CCI)用于评估合并症风险。对有并发症和无并发症的患者进行了曼-惠特尼检验和费雪精确检验:在接受 SpaceOAR 治疗的 233 名患者中,有 24 人(10.3%)出现了毒性反应。所有并发症均为克拉维恩Ⅰ型或Ⅱ型,如置入后盆腔疼痛、盆腔充盈、出血和下尿路症状。16名患者(6.9%)的部分水凝胶注射到了直肠壁,但并无明显临床症状。出现并发症的患者平均 CCI 为 3.2 ± 0.95;无并发症组的平均 CCI 为 3.6 ± 1.6(P=0.48)。在手术量较大的医生中,1 号医生的患者报告并发症发生率最高,68 例中有 11 例(16.2%),2 号医生的并发症发生率最低,96 例中有 4 例(4.2%)。多变量分析发现,之前接受过激素治疗的患者在植入 SpaceOAR 后报告并发症的几率较低:结论:在单变量分析中,手术中列出的主治医生与 SpaceOAR 置入术后并发症有显著相关性;在多变量分析中,激素治疗对手术耐受性有一定益处。总体而言,水凝胶置入术的耐受性良好,与手术相关的轻度和短暂毒性发生率较低。
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Complications and Influential Perioperative Factors Associated with SpaceOAR Hydrogel Placement.

Objective: To examine one academic institution's experiences with SpaceOAR placement, its associated complications, and periprocedural characteristics that affect outcomes for the purpose of quality improvement.

Materials and methods: We conducted a retrospective review of 233 patients who received SpaceOAR from four surgeons and one radiation oncologist between 2018 and 2021. Variables such as demographics, oncologic parameters, radiation plan, and radiographic assessment of hydrogel placement were recorded. The Charlson Comorbidity Index (CCI) was used to assess comorbidity risk. Mann-Whitney and Fisher's exact tests were performed to compare patients with and without complications.

Results: Of the 233 patients who received SpaceOAR, 24 (10.3%) experienced toxicity. All complications were Clavien I or II, such as pelvic pain postplacement, pelvic fullness, bleeding, and lower urinary tract symptoms. 16 patients (6.9%) had some portion of the hydrogel injected into the rectal wall, but it was never clinically significant. The average CCI was 3.2 ± 0.95 for patients who experienced complications; the average CCI was 3.6 ± 1.6 (p=0.48) in the group without complications. Of the physicians with higher procedure volumes, Physician #1 had the highest rate of patient-reported complications at 11 out of 68 (16.2%) and Physician #2 had the lowest rate of complications at 4 out of 96 placements (4.2%). Multivariate analysis found that patients who had received hormone therapy previously had less odds of reporting complications after SpaceOAR placement.

Conclusions: The listed attending on the procedure had a significant correlation to complications with SpaceOAR placement on univariate analysis, and hormone therapy had some benefits to the tolerance for the procedure on multivariate analysis. Overall, the hydrogel placement was well tolerated with low incidence of mild and transient procedure-related toxicity.

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来源期刊
Advances in Urology
Advances in Urology UROLOGY & NEPHROLOGY-
CiteScore
2.90
自引率
0.00%
发文量
17
审稿时长
15 weeks
期刊介绍: Advances in Urology is a peer-reviewed, open access journal that publishes state-of-the-art reviews and original research papers of wide interest in all fields of urology. The journal strives to provide publication of important manuscripts to the widest possible audience worldwide, without the constraints of expensive, hard-to-access, traditional bound journals. Advances in Urology is designed to improve publication access of both well-established urologic scientists and less well-established writers, by allowing interested scientists worldwide to participate fully.
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