scholarly journals Predictors of complications occurring after open and robot-assisted prostate cancer surgery: a retrospective evaluation of 1062 consecutive patients treated in a tertiary referral high volume center

2021 ◽  
Author(s):  
Antonio Benito Porcaro ◽  
Alessandro Tafuri ◽  
Riccardo Rizzetto ◽  
Nelia Amigoni ◽  
Marco Sebben ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Postoperative Complications ◽  
Radical Prostatectomy ◽  
Blood Loss ◽  
Open Approach ◽  
Intraoperative Blood Loss ◽  
Tertiary Referral ◽  
Robot Assisted ◽  
The Third ◽  
Major Complications

AbstractTo investigate factors associated with the risk of major complications after radical prostatectomy (RP) by the open (ORP) or robot-assisted (RARP) approach for prostate cancer (PCa) in a tertiary referral center. 1062 consecutive patients submitted to RP were prospectively collected. The following outcomes were addressed: (1) overall postoperative complications: subjects with Clavien-Dindo System (CD) one through five versus cases without any complication; (2) moderate to major postoperative complications: cases with CD < 2 vs.  ≥ 2, and 3) major post-operative complications: subjects with CDS CD ≥  3 vs.  < 3. The association of pre-operative and intra-operative factors with the risk of postoperative complications was assessed by the logistic regression model. Overall, complications occurred in 310 out of 1062 subjects (29.2%). Major complications occurred in 58 cases (5.5%). On multivariate analysis, major complications were predicted by PCa surgery and intraoperative estimated blood loss (EBL). ORP compared to RARP increased the risk of major CD complications from 2.8 to 19.3% (OR = 8283; p < 0.0001). Performing ePLND increased the risk of major complications from 2.4 to 7.4% (OR = 3090; p < 0.0001). Assessing intraoperative blood loss, the risk of major postoperative complications was increased by BL above the third quartile when compared to subjects with intraoperative blood loss up to the third quartile (10.2% vs. 4.6%; OR = 2239; 95%CI: 1233–4064). In the present cohort, radical prostatectomy showed major postoperative complications that were independently predicted by the open approach, extended lymph-node dissection, and excessive intraoperative blood loss.

scholarly journals Severe intraoperative bleeding predicts the risk of perioperative blood transfusion after robot-assisted radical prostatectomy

2021 ◽  
Author(s):  
Antonio Benito Porcaro ◽  
Riccardo Rizzetto ◽  
Nelia Amigoni ◽  
Alessandro Tafuri ◽  
Aliasger Shakir ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Univariate Analysis ◽  
Operating Time ◽  
Primary Treatment ◽  
Intraoperative Blood Loss ◽  
Robot Assisted ◽  
Intraoperative Bleeding ◽  
Perioperative Blood Transfusion

AbstractTo evaluate potential factors associated with the risk of perioperative blood transfusion (PBT) with implications on length of hospital stay (LOHS) and major post-operative complications in patients who underwent robot-assisted radical prostatectomy (RARP) as a primary treatment for prostate cancer (PCa). In a period ranging from January 2013 to August 2019, 980 consecutive patients who underwent RARP were retrospectively evaluated. Clinical factors such as intraoperative blood loss were evaluated. The association of factors with the risk of PBT was investigated by statistical methods. Overall, PBT was necessary in 39 patients (4%) in whom four were intraoperatively. Positive surgical margins, operating time and intraoperative blood loss were associated with perioperative blood transfusion on univariate analysis. On multivariate analysis, the risk of PBT was predicted by intraoperative blood loss (odds ratio, OR 1.002; 95% CI 1.001–1.002; p < 0.0001), which was associated with prolonged operating time and elevated body mass index (BMI). PBT was associated with delayed LOHS and Clavien–Dindo complications > 2. In patients undergoing RARP as a primary treatment for PCa, the risk of PBT represented a rare event that was predicted by severe intraoperative bleeding, which was associated with increased BMI as well as with prolonged operating time. In patients who received a PBT, prolonged LOHS as well as an elevated risk of major Clavien–Dindo complications were seen.

scholarly journals Single plus one port robotic radical prostatectomy (SPORP); Initial experience

2017 ◽  
Vol 89 (3) ◽  
pp. 178 ◽  
Author(s):  
Volkan Tugcu ◽  
Abdulmuttalip Simsek ◽  
Ismail Evren ◽  
Kamil Gokhan Seker ◽  
Ramazan Kocakaya ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Postoperative Complications ◽  
Radical Prostatectomy ◽  
Serum Level ◽  
Blood Loss ◽  
Clinical Stage ◽  
Operating Time ◽  
Positive Surgical Margin ◽  
Robotic Radical Prostatectomy ◽  
Postoperative Continence

Objective: This article reports on patients with early stage prostate cancer treated with single plus one port robotic radical prostatectomy (SPORP). Materials and methods: Since January 2014, we performed SPORP in 8 patients with localized prostate cancer. Age of patients, clinical stage, operation time, intraoperative and postoperative complications, blood loss, histopathological evaluation, postoperative continence, serum level of PSA were evaluated. Results: Mean age of the 8 patients was 59.85 years. All operations were completed without conversion to standard robotic procedure or open surgery. No intra operative complications occurred. Mean operating time was 143 minutes; prostate excision 123 minutes and urethrovesical anastomosis 20 minutes. Mean blood loss was 45 ml. Preoperative Gleason scores were (3 + 4) in one patient and (3 + 3) in 7 patients. Postoperative Gleason scores were (3 + 4) in 2 patients, and (3 + 3) in 6 patients. All these 8 cases were in T1c clinical stage. Early postoperative complications were drain leakage (n = 1), atelectasis (n = 1), wound infection (n = 1) and fever (n = 1). There was no positive surgical margin. The serum level of PSA was less than 0.2 ng/ml and no other complications happened during the 4 to 12 months follow-up period. Postoperative continence and cosmetic results were excellent. Conclusions: It is relatively easy for urologists who are skilled in traditional laparoscopic and robotic surgeries to master SPORP. However long-term outcomes of this surgery need further investigations.

scholarly journals A meta-analysis of robot assisted laparoscopic radical prostatectomy versus laparoscopic radical prostatectomy

Open Medicine ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 485-490 ◽  
Author(s):  
Tao Wang ◽  
Qunsuo Wang ◽  
Songtao Wang
Keyword(s):  
Prostate Cancer ◽  
Postoperative Complications ◽  
Radical Prostatectomy ◽  
Meta Analysis ◽  
Surgical Margin ◽  
Laparoscopic Radical Prostatectomy ◽  
Localized Prostate Cancer ◽  
Urinary Continence ◽  
Robot Assisted ◽  
Continence Rate

AbstractObjectiveTo evaluate the efficacy and safety of robot-assisted laparoscopic radical prostatectomy (RALP) and laparoscopic radical prostatectomy (LRP) for the treatment of localized prostate cancer.MethodsMeta-analysis was applied using Review Manager V5.3 software and the retrieved clinical trials comparing RALP with LRP for the treatment of localized prostate cancer published from 2000 to 2018 in PubMed, Ovid, ScienceDirect, and EMBASE datasets were analyzed.ResultsThis meta-analysis included 16 articles, totaling 7952 patients, with 5170 RALP patients and 2782 LRP patients. Meta-analysis showed that RALP postoperative complications were fewer (P=0.0007), and the postoperative urinary continence rate was better at 1 year after surgery (P<0.00001). There was no statistical significance between RALP and LRP with regards to the positive incidence of surgical margin (P = 0.18).ConclusionAs an emerging technology, RALP is superior to LRP for localized prostate cancer treatment in terms of postoperative complications, and postoperative urinary continence rate.

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