腹腔鏡下膀胱全摘除術は本邦に安全に導入されたか? : 本邦多施設共同研究での導入初期症例における治療成績の検討

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タイトル別名
  • The Safety of Laparoscopic Radical Cystectomy during Initial Phases in a Japanese Multicenter Cohort
  • フククウキョウ カ ボウコウ ゼンテキジョジュツ ワ ホンポウ ニ アンゼン ニ ドウニュウ サレタ カ? : ホンポウ タシセツ キョウドウ ケンキュウ デ ノ ドウニュウ ショキ ショウレイ ニ オケル チリョウ セイセキ ノ ケントウ

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抄録

We evaluated the safety of laparoscopic radical cystectomy (LRC) during initial phases and its learning curve in a Japanese multicenter cohort by studying 436 patients who underwent LRC with no robot assistance at 10 institutions in Japan. We divided the patients into three groups according to cumulative surgical volume at each institution (first 10 cases, 11-30 cases, after 31 cases in each institution), and compared perioperative and pathologic variables among the three groups. The first, second, and third groups included 100, 166, 170 patients, respectively. The preoperative variables were similar in the three groups except for the rate of neoadjuvant chemotherapy. The methods of LRC procedure, such as urinary diversion, the extent of lymph node dissection, and concomitant urethrectomy or nephroureterectomy, were similar in the three groups. Mean operative time was 629, 562 and 531 minutes, respectively, and mean blood loss was 755, 650 and 435 ml, respectively. Both values decreased over time with the institution's experience. There was no significant difference among the three groups in the rate of positive surgical margin, the number of retrieved lymph nodes, and the rate of intra- and postoperative complications. LRC was safely performed during initial phases with an acceptable complication rate and without compromising oncological results, although operative time was longer and blood loss increased.

収録刊行物

  • 泌尿器科紀要

    泌尿器科紀要 65 (11), 439-444, 2019-11-30

    泌尿器科紀要刊行会

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