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Vol. 45. Issue 4.
Pages 281-288 (May 2021)
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Vol. 45. Issue 4.
Pages 281-288 (May 2021)
Original article
DOI: 10.1016/j.acuroe.2021.03.003
Live surgery: Safety study after 17 editions of retroperitoneoscopic surgery
Cirugía en directo: estudio de seguridad tras 17 ediciones de cirugía retroperitoneoscópica
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Mario Andrés Rosado-Urteaga
Corresponding author
mariorosado1986@gmail.com

Corresponding author.
, Ángel Prera, Jesús Muñoz, Arturo Domínguez, Anna Ferran, José Luis González, Darío García, Joan Prats
Servicio de urología, Hospital Universitari Parc Taulí, Barcelona, Spain
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Tables (4)
Table 1. Clinical features.
Table 2. Comparison of perioperative variables, complications and evolution of partial nephrectomy.
Table 3. Comparison of perioperative variables, complications and evolution of radical nephrectomy.
Table 4. Comparison of perioperative variables, complications and evolution of nephroureterectomy.
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Abstract
Introduction

Live surgery has become an excellent tool for medical training. Despite this, there is controversy about the safety of the patients involved.

Objective

To analyze the results of live surgeries performed in 17 consecutive retroperitoneoscopy courses organized in our center. Procedures performed were partial nephrectomy (PN), radical nephrectomy (RN) and nephroureterectomy (NU).

Material and methods

Review from January 2010 to October 2017 of all live surgeries carried out by an expert surgical team in the retroperitoneoscopy courses, compared with a control group of surgeries performed in standard conditions. A matching (1:1 for each RN and 1:2 for each PN and NU) according to age, body mass index and comorbidities was performed.

Results

Twenty-one live surgeries were analyzed (eight PN, seven RN and six NU) with a global median follow-up of 38 months. No significant differences were observed between both groups in terms of perioperative variables (operative time, operative bleeding and intraoperative complications) or of postoperative complications and length of hospital stay. Likewise, there were no differences between recurrence rates (PN: 0% vs 6.3%, p = 0.47, NU: 33.3% vs 66.7%, p = 0.180, RN: 0% vs 28.6%, p = 0,127).

Conclusions

Live surgery in the hands of expert surgeons in a suitable environment and with well-selected patients does not increase the risk of complications and allows maintaining the same oncological outcomes.

Keywords:
Live surgery
Retroperitoneoscopy
Nephrectomy
Safety
Complications
Resumen
Introducción

La cirugía en directo se ha convertido en una excelente herramienta para la formación médica. Pese a ello, existe controversia sobre la seguridad de los pacientes que participan.

Objetivo

Analizar los resultados de las cirugías en directo realizadas en 17 cursos consecutivos de retroperitoneoscopia organizados en nuestro centro, en los cuales se intervinieron nefrectomías parciales (NP), nefrectomías radicales (NR) y nefroureterectomías (NU).

Material y métodos

Revisión realizada desde enero de 2010 a octubre de 2017 de todas las cirugías en directo ejecutadas por un equipo quirúrgico experto en los cursos de retroperitoneoscopia, comparadas con un grupo control de cirugías realizadas de forma ordinaria y que fue apareado con relación a la edad, índice de masa corporal y comorbilidades (1:1 por cada NR y 1:2 por cada NP y NU).

Resultados

Se analizaron 21 cirugías en directo (8 NP, 7 NR y 6 NU) con una mediana de seguimiento global de 38 meses. No se observaron diferencias significativas entre las cirugías de los cursos y los controles en cuanto a variables perioperatorias (tiempo quirúrgico, sangrado operatorio y complicaciones intraoperatorias) ni en las complicaciones postoperatorias y días de ingreso. Tampoco encontramos diferencias en la tasa de recidiva en los tres grupos (NP: 0% vs 6.3%, p = 0.47, NU: 33.3% vs 66.7%, p = 0.180, NR: 0% vs 28.6%, p = 0,127).

Conclusión

La cirugía en directo realizada por cirujanos expertos en un ambiente adecuado y con pacientes idóneos no representa un riesgo añadido de complicaciones para los pacientes y permite mantener los mismos resultados oncológicos.

Palabras clave:
Cirugía en directo
Retroperitoneoscopia
Nefrectomía
Seguridad
Complicaciones

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