ABSTRACT
ABSTRACT Introduction: The increasing adoption of robotic-assisted cystectomy with intracorporeal urinary diversion (ICUD), despite its complexity, prompts a detailed comparison with extracorporeal urinary diversion (ECUD). Our study at a single institution investigates perioperative outcomes and identifies risk factors impacting the success of these surgical approaches. Methods: In this retrospective analysis, 174 patients who underwent robotic-assisted cystectomy at the University of Louisville from June 2016 to August 2021 were reviewed. The cohort was divided into two groups based on the urinary diversion method: 30 patients underwent ECUD and 144 underwent ICUD. Data on demographics, complication rates, length of hospital stay, and readmission rates were meticulously collected and analyzed. Results: Operative times were comparable between the ICUD and ECUD groups. However, the ICUD group had a significantly lower intraoperative transfusion rate (0.5 vs. 1.0, p=0.02) and shorter hospital stay (7.8 vs. 12.3 days, p<0.001). Factors such as male sex, smoking history, diabetes mellitus, intravesical therapy, higher ASA, and ACCI scores were associated with increased Clavien-Dindo Grade 3 or higher complications. Age over 70 was the sole factor linked to a higher 90-day readmission rate, with no specific characteristics influencing the 30-day rate. Conclusion: Robotic cystectomy with ICUD results in shorter hospitalizations and lower intraoperative transfusion rates compared to ECUD, without differences in operative time, high-grade postoperative complications, or readmission rates. These findings can inform clinical decision-making, highlighting ICUD as a potentially more favorable option in appropriate settings.
ABSTRACT
O estudo teve como objetivo caracterizar o ciclo menstrual no tocante à síndrome pré-menstrual, à antropometria e aoconsumo alimentar. Foi realizada a avaliação de medidas antropométricas e do consumo alimentar na fase folicular e nafase lútea do ciclo menstrual. Sintomas pré-menstruais foram averiguados por meio de um diário padronizado. Foramavaliadas 40 estudantes, com média de idade de 22,57 ± 1,97 anos. Não houve diferença de peso entre as duas fasesdo ciclo menstrual (p > 0,05), porém verificou-se maior média de circunferência de cintura (p=0,021) e de percentualde gordura corporal (p=0,019) na fase lútea, maior frequência de consumo excessivo de doces (p=0,020), chocolate(p=0,029), refrigerantes do tipo diet (p=0,009) e café (p < 0,001) nessa fase, apesar da similaridade na ingestão de macroe micronutrientes (p > 0,05). Concluiu-se que ocorrem mudanças na composição corporal e no comportamento alimentare maior gravidade de sintomas na fase lútea do ciclo menstrual, denotando a importância do aconselhamento nutricional.
The study aimed to portray the menstrual cycle relating it to premenstrual syndrome, to anthropometry and to feedingbehavior aspects. Anthropometric and dietary intake assessments were conducted on follicular and luteal phases of themenstrual cycle. Premenstrual symptoms were investigated through an outlined journal. Forty students, with a mean ageof 22.57 ± 1.97 years were assessed. It was not attested any differences in weight between the two phases (p > 0.05). However,a higher waist circumference (p=0.021) and a higher body fat percentage (p = 0.019) were noticed during the lutealphase. An excessive ingestion of sweets (p=0.020), chocolate (p=0.029), diet soft drinks (p=0.009) and coffee (p < 0.001)was also noted in this phase, despite the similarity in the macro and micronutrient consumption. It was concluded thatchanges in body composition and food behavior and more severe symptoms occur on the luteal phase of the menstrualcycle indicating the importance of nutritional counseling.