| アブストラクト | OBJECTIVE: To clarify the trends in radical cystectomy and to compare surgical outcomes among surgical approaches focusing on robot-assisted radical cystectomy based on a Japanese nationwide database. METHODS: The Diagnosis Procedure Combination database was used to extract data on radical cystectomy cases. Trends in open radical cystectomy, laparoscopic radical cystectomy, minimum incision endoscopic radical cystectomy, and robot-assisted radical cystectomy between April 2012 and March 2021 were evaluated. Basic characteristics and peri-operative indicators were compared among the four groups. Propensity score matching was applied to assess the differences between open radical cystectomy and robot-assisted radical cystectomy. RESULTS: During the study period, a decreasing number of open radical cystectomies and an increasing number of minimally invasive radical cystectomies were shown in the total cohort of 28 345 cases. The number of robot-assisted radical cystectomies rapidly increased after government approval in 2018. Minimally invasive radical cystectomies, including robot-assisted radical cystectomies, had a significantly lower complication rate, a shorter length of stay, and a lower blood transfusion rate, but a longer anesthesia time than open radical cystectomies. In the propensity score matching analysis comparing the surgical outcomes of robot-assisted radical cystectomy and open radical cystectomy, similar results were demonstrated, and blood transfusion rates were equivalent. CONCLUSION: For the past decade, the number of minimally invasive radical cystectomies has steadily increased without compromised surgical outcomes, except for anesthesia time. Robot-assisted radical cystectomies in particular rapidly became widespread in Japan after government approval in 2018 and became a standard surgery within the first 3 years. |
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| ジャーナル名 | International journal of urology : official journal of the Japanese Urological Association |
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| Pubmed追加日 | 2022/12/16 |
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| 投稿者 | Chen, Wei; Yokoyama, Minato; Kobayashi, Masaki; Fan, Bo; Fukuda, Shohei; Waseda, Yuma; Tanaka, Hajime; Yoshida, Soichiro; Ai, Masumi; Fushimi, Kiyohide; Nonomura, Norio; Fujii, Yasuhisa |
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| 組織名 | Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan.;Department of Insured Medical Care Management, Tokyo Medical and Dental;University, Tokyo, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University,;Tokyo, Japan.;Department of Urology, Osaka University Graduate School of Medicine, Suita,;Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/36520885/ |
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