1
|
Quinto D, Reis ST, Zampolli LJ, Pimenta R, Guimarães VR, Viana NI, Dos Santos GA, Gimenez MP, Leite KR, Zampolli H, da Cruz JAS, Srougi M, Passerotti CC. Robotically assisted laparoscopic radical prostatectomy induces lower tissue trauma than radical retropubic prostatectomy. J Robot Surg 2020; 15:147-151. [PMID: 33009987 DOI: 10.1007/s11701-020-01150-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/25/2020] [Indexed: 11/25/2022]
Abstract
To compare tissue trauma between Retropubic Radical Prostatectomy and Robotically Assisted Laparoscopic Radical Prostatectomy by inflammatory mediators. Serum samples from 40 patients submitted to RALP and 20 patients submitted to RRP were withdrawn at four different time points. The cytokines IL-4, IL-8, IL-6, IL-1B, IL-10 and TNF-α were detected using ELISA/Multiplex assays and xMAP-Luminex®. With both techniques, IL-10 and IL-6 were higher in T4 than in T1-T3 (p = 0.001). IL-10 and IL-6 were higher in T4 in open surgery than in robotic surgery (p = 0.000 and p = 0.001, respectively). Compared with both groups, IL-6 and IL-10 were higher in T4 in open surgery than in robotic surgery. Thus, we can postulate that RALP causes less tissue trauma than classical RRP, as indicated by the more limited increase in inflammatory mediators such as IL-6 and IL-10.
Collapse
Affiliation(s)
- Denise Quinto
- Center for Robotic Surgery, Hospital Alemão Oswaldo Cruz, São Paulo, 01327-001, Brazil
| | - Sabrina T Reis
- Laboratory of Medical Investigation (LIM55), Urology Department, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av. Dr. Arnaldo 455, 2° andar, sala 2141 - Cerqueira César, São Paulo, SP, 01246-903, Brazil. .,Faculdade Atenas - Campus Passos, Passos, 37900-380, Brazil.
| | - Lucca Juvele Zampolli
- Laboratory of Medical Investigation (LIM55), Urology Department, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av. Dr. Arnaldo 455, 2° andar, sala 2141 - Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Ruan Pimenta
- Laboratory of Medical Investigation (LIM55), Urology Department, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av. Dr. Arnaldo 455, 2° andar, sala 2141 - Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Vanessa R Guimarães
- Laboratory of Medical Investigation (LIM55), Urology Department, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av. Dr. Arnaldo 455, 2° andar, sala 2141 - Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Nayara I Viana
- Laboratory of Medical Investigation (LIM55), Urology Department, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av. Dr. Arnaldo 455, 2° andar, sala 2141 - Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Gabriel A Dos Santos
- Laboratory of Medical Investigation (LIM55), Urology Department, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av. Dr. Arnaldo 455, 2° andar, sala 2141 - Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Mario P Gimenez
- Center for Robotic Surgery, Hospital Alemão Oswaldo Cruz, São Paulo, 01327-001, Brazil
| | - Katia R Leite
- Laboratory of Medical Investigation (LIM55), Urology Department, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av. Dr. Arnaldo 455, 2° andar, sala 2141 - Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Hamilton Zampolli
- Center for Robotic Surgery, Hospital Alemão Oswaldo Cruz, São Paulo, 01327-001, Brazil
| | | | - Miguel Srougi
- Laboratory of Medical Investigation (LIM55), Urology Department, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av. Dr. Arnaldo 455, 2° andar, sala 2141 - Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Carlo C Passerotti
- Center for Robotic Surgery, Hospital Alemão Oswaldo Cruz, São Paulo, 01327-001, Brazil.,Laboratory of Medical Investigation (LIM55), Urology Department, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av. Dr. Arnaldo 455, 2° andar, sala 2141 - Cerqueira César, São Paulo, SP, 01246-903, Brazil
| |
Collapse
|
2
|
dos Reis Júnior A, Quinto D. Digital block with or without the addition of epinephrine in the anesthetic solution. Braz J Anesthesiol 2016; 66:63-71. [PMID: 26768932 DOI: 10.1016/j.bjane.2013.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 12/03/2013] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Review of various techniques for digital blocks with local anesthetic, with or without epinephrine. CONTENTS Description of various procedures and comparison of results reported in the literature, mainly on latency and quality of anesthesia, details on vasoconstrictor effect of epinephrine, intraoperative bleeding, necessity of tourniquet use, duration of anesthesia and postoperative analgesia, blood flow and digital SpO2 behavior, local and systemic complications, and also approaches and drugs to be used in certain situations of ischemia. CONCLUSIONS The advantages of adding epinephrine to the anesthetic solution are minor when compared to the risks of the procedure, and it seems dangerous to use a vasoconstrictor in the fingers, unless the safety of the technique and the possibility of discarding the tourniquet are definitely proven.
Collapse
Key Words
- Anestesia, regional
- Anesthesia, regional
- Anestésicos locais, cocaína, lidocaína, bupivacaína, ropivacaína
- Cirurgia, dedos de mãos
- Ischemia, epinephrine
- Isquemia, epinefrina
- Local anesthetics, cocaine, lidocaine, bupivacaine, ropivacaine
- Surgery, fingers
Collapse
Affiliation(s)
- Almiro dos Reis Júnior
- Serviço Médico de Anestesia (SMA), São Paulo, SP, Brazil; Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil; Sociedade de Anestesiologia do Estado de São Paulo (Saesp), São Paulo, SP, Brazil.
| | - Denise Quinto
- Serviço Médico de Anestesia (SMA), São Paulo, SP, Brazil; Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil
| |
Collapse
|
3
|
Reis Júnior AD, Quinto D. [Digital block with or without the addition of epinephrine in the anesthetic solution]. Rev Bras Anestesiol 2015; 66:63-71. [PMID: 26004996 DOI: 10.1016/j.bjan.2013.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 12/03/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Review of various techniques for digital blocks with local anesthetic, with or without epinephrine. CONTENTS Description of various procedures and comparison of results reported in the literature, mainly on latency and quality of anesthesia, details on vasoconstrictor effect of epinephrine, intraoperative bleeding, necessity of tourniquet use, duration of anesthesia and postoperative analgesia, blood flow and digital SpO2 behavior, local and systemic complications, and also approaches and drugs to be used in certain situations of ischemia. CONCLUSIONS The advantages of adding epinephrine to the anesthetic solution are minor when compared to the risks of the procedure, and it seems dangerous to use a vasoconstrictor in the fingers, unless the safety of the technique and the possibility of discarding the tourniquet are definitely proven.
Collapse
Key Words
- Anestesia, regional
- Anesthesia, regional
- Anestésicos locais, cocaína, lidocaína, bupivacaína, ropivacaína
- Cirurgia, dedos de mãos
- Ischemia, epinephrine
- Isquemia, epinefrina
- Local anesthetics, cocaine, lidocaine, bupivacaine, ropivacaine
- Surgery, fingers
Collapse
Affiliation(s)
- Almiro Dos Reis Júnior
- Serviço Médico de Anestesia (SMA), São Paulo, SP, Brasil; Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brasil; Sociedade de Anestesiologia do Estado de São Paulo (Saesp), São Paulo, SP, Brasil.
| | - Denise Quinto
- Serviço Médico de Anestesia (SMA), São Paulo, SP, Brasil; Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brasil
| |
Collapse
|