Waleed Mohamed Fadlalla, Ayman Hanafy, Mahmoud Abdelhakim, Hatem Aboulkassem, El Sayed Ashraf, Ahmed Abdelbary
{"title":"腹腔镜与开放式根治性膀胱切除术的随机对照试验Naïve中心。","authors":"Waleed Mohamed Fadlalla, Ayman Hanafy, Mahmoud Abdelhakim, Hatem Aboulkassem, El Sayed Ashraf, Ahmed Abdelbary","doi":"10.1155/2021/4731013","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic radical cystectomy is a challenging surgical procedure; however, it has been largely abandoned in favor of the more intuitive robotic-assisted cystectomy. Due to the prohibitive cost of robotic surgery, the adoption of laparoscopic cystectomy is of relevance in low-resource institutes. <i>Methodology</i>. This is a randomized controlled trial comparing laparoscopic radical cystectomy (LRC) to open radical cystectomy (ORC) at a single institute. Each group included thirty patients. The trial was designed to compare both approaches regarding operative time, blood loss, transfusion requirements, length of hospital stay, time to oral intake, requirement of opioid analgesia, and complications.</p><p><strong>Results: </strong>LRC was associated with less hospital stay (9.8 vs. 13.8 days, <i>P</i>=0.001), less time to oral solid intake (6 vs. 8.6 days, <i>P</i>=0.031), and lower opioid requirements (23.3% vs. 53.3%, <i>P</i>=0.033). There was a trend towards lower blood loss and transfusion requirements, but this did not reach statistical significance. Overall complication rates were comparable.</p><p><strong>Conclusion: </strong>Laparoscopic radical cystectomy was associated with comparable postoperative outcomes when compared to ORC in the first laparoscopic cystectomy experience in our center. Benefitting from the assistance of an experienced laparoscopic surgeon is recommended to shorten the learning curve.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2021 ","pages":"4731013"},"PeriodicalIF":1.8000,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8279872/pdf/","citationCount":"2","resultStr":"{\"title\":\"Randomized Controlled Trial of Laparoscopic versus Open Radical Cystectomy in a Laparoscopic Naïve Center.\",\"authors\":\"Waleed Mohamed Fadlalla, Ayman Hanafy, Mahmoud Abdelhakim, Hatem Aboulkassem, El Sayed Ashraf, Ahmed Abdelbary\",\"doi\":\"10.1155/2021/4731013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Laparoscopic radical cystectomy is a challenging surgical procedure; however, it has been largely abandoned in favor of the more intuitive robotic-assisted cystectomy. Due to the prohibitive cost of robotic surgery, the adoption of laparoscopic cystectomy is of relevance in low-resource institutes. <i>Methodology</i>. This is a randomized controlled trial comparing laparoscopic radical cystectomy (LRC) to open radical cystectomy (ORC) at a single institute. Each group included thirty patients. The trial was designed to compare both approaches regarding operative time, blood loss, transfusion requirements, length of hospital stay, time to oral intake, requirement of opioid analgesia, and complications.</p><p><strong>Results: </strong>LRC was associated with less hospital stay (9.8 vs. 13.8 days, <i>P</i>=0.001), less time to oral solid intake (6 vs. 8.6 days, <i>P</i>=0.031), and lower opioid requirements (23.3% vs. 53.3%, <i>P</i>=0.033). There was a trend towards lower blood loss and transfusion requirements, but this did not reach statistical significance. Overall complication rates were comparable.</p><p><strong>Conclusion: </strong>Laparoscopic radical cystectomy was associated with comparable postoperative outcomes when compared to ORC in the first laparoscopic cystectomy experience in our center. Benefitting from the assistance of an experienced laparoscopic surgeon is recommended to shorten the learning curve.</p>\",\"PeriodicalId\":7490,\"journal\":{\"name\":\"Advances in Urology\",\"volume\":\"2021 \",\"pages\":\"4731013\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2021-07-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8279872/pdf/\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Advances in Urology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2021/4731013\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in Urology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2021/4731013","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Randomized Controlled Trial of Laparoscopic versus Open Radical Cystectomy in a Laparoscopic Naïve Center.
Background: Laparoscopic radical cystectomy is a challenging surgical procedure; however, it has been largely abandoned in favor of the more intuitive robotic-assisted cystectomy. Due to the prohibitive cost of robotic surgery, the adoption of laparoscopic cystectomy is of relevance in low-resource institutes. Methodology. This is a randomized controlled trial comparing laparoscopic radical cystectomy (LRC) to open radical cystectomy (ORC) at a single institute. Each group included thirty patients. The trial was designed to compare both approaches regarding operative time, blood loss, transfusion requirements, length of hospital stay, time to oral intake, requirement of opioid analgesia, and complications.
Results: LRC was associated with less hospital stay (9.8 vs. 13.8 days, P=0.001), less time to oral solid intake (6 vs. 8.6 days, P=0.031), and lower opioid requirements (23.3% vs. 53.3%, P=0.033). There was a trend towards lower blood loss and transfusion requirements, but this did not reach statistical significance. Overall complication rates were comparable.
Conclusion: Laparoscopic radical cystectomy was associated with comparable postoperative outcomes when compared to ORC in the first laparoscopic cystectomy experience in our center. Benefitting from the assistance of an experienced laparoscopic surgeon is recommended to shorten the learning curve.
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.