RESUMO
Surgeon controlled robot-assisted laparoscopic radical cystectomy (RARC) is becoming a viable treatment option for patients with muscle-invasive bladder cancer. There are currently several single-institution reports and a few multi-institutional reports on operative, perioperative, and intermediate-term oncologic outcomes for RARC. While the data appears promising, there is currently no long term oncologic outcomes for RARC. Long-term oncologic outcomes for RARC should be forthcoming in the near future. As the technology improves, and surgeons become more proficient at RARC, the cost effectiveness of RARC should surpass open radical cystectomy. The goal of this article is to review the most recent developments within the past 1 to 2 years surrounding RARC, including important technical advances for performing this operation, current data on oncologic outcomes, and the future direction of RARC.
Assuntos
Cistectomia/instrumentação , Laparoscopia , Papel do Médico , Robótica , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgia , Competência Clínica , Cistectomia/métodos , Cistectomia/tendências , Medicina Baseada em Evidências , Humanos , Laparoscopia/tendências , Invasividade Neoplásica , Estadiamento de Neoplasias , Qualidade de Vida , Resultado do Tratamento , Derivação UrináriaRESUMO
This paper reviews the livestock situation in the Caribbean countries including animal populations, common disease problems and some of the factors relating to disease control. It refers to the particular training needs of veterinarians that would best serve the type of epidemiological investigations required to control diseases in the area. It emphasizes the practical approach and considerations that veterinarians must exercise in dealing with the particular sociological and cultural factors of each country. Reference is also made to the problems of training and then retaining an adequate number of veterinarians in the area.
