Year: 2018
Type: article
Study design: Observational Study
Abstract: METHODS: Our study population of 56 patients underwent MUOS over a period of 6 years (2011-17) with their medical records retrospectively reviewed.RESULTS: The mean age of our study population was 57.1 years (23-89 years), with surgeries performed consisting of radical nephrectomy in 39 (70% total): 33% of those associated with extensive retroperitoneal lymph node dissection (RPLND) 16% with renal vein thrombectomy, 14% with IVC thrombectomy and 10% requiring distal pancreatectomy and splenectomy).15 RPLNDs (26% of total) were performed for testicular cancer or other retroperitoneal malignancies (such as schwannomas).The mean surgery time was 226 minutes (60-720) and the mean estimated intra-operative blood loss was 972 mL (100-5110 mL).On the perioperative setting, packed red blood cells (pRBC) were ordered by the surgeon, from 2 to 24 units, with a mean value of 10.2.Regarding the use of products at time of surgery, crystalloids were the principal fluid used for resuscitation, with a mean use of 3.5 L. A mean of 2.1 units (0-16 units) pRBCs were transfused.Frozen plasma was transfused in only 6 cases (mean 2.2 units) and platelets in 4 cases (mean 1.1 unit).The mean length of stay in our study was of 6.62 days (2-22 days), with very low intensive care stay (10 patients, for a mean time of 0.37 days).Most importantly, a very low complication rate, of only 10% was observed: 33%, of Clavien-Dindo class I.There was only one case of class IV complication: an ischemic stroke on a 79 years old patient.A low incidence of readmission was also observed (overall 16% at 30 days post-op period).CONCLUSIONS: The present study highlights that the institution of an MTP can have favorable treatment related and cost benefit endpoints within the field of MUOS especially on procedures deemed at high risk of significant blood loss.Major cancer centers performing such procedures may want to consider adopting similar protocols in the appropriate clinical setting.
Source: The Journal of Urology
Institution: Parker Hannifin (United States)
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2795903266