815: Does Obesity Increase Intraoperative and Postoperative Complications in Men Undergoing Radical Prostatectomy?

2004 ◽  
Vol 171 (4S) ◽  
pp. 215-216
Author(s):  
Christopher L. Amling ◽  
Sara R. Williams ◽  
Raymond S. Lance ◽  
David G. McLeod ◽  
Leo Kusuda ◽  
...  
Author(s):  
Antonio Benito Porcaro ◽  
Alessandro Tafuri ◽  
Riccardo Rizzetto ◽  
Nelia Amigoni ◽  
Marco Sebben ◽  
...  

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.


2017 ◽  
Vol 89 (3) ◽  
pp. 178 ◽  
Author(s):  
Volkan Tugcu ◽  
Abdulmuttalip Simsek ◽  
Ismail Evren ◽  
Kamil Gokhan Seker ◽  
Ramazan Kocakaya ◽  
...  

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.


2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092007
Author(s):  
Ying Xu ◽  
Ao Liu ◽  
Lu Chen ◽  
Hai Huang ◽  
Yi Gao ◽  
...  

Objective To evaluate the impact of an enhanced recovery after surgery (ERAS) pathway on patients undergoing minimally invasive radical prostatectomy at a single institute. Methods In this retrospective study, 301 patients who underwent laparoscopic or robot-assisted laparoscopic radical prostatectomy from May 2014 to September 2018 were consecutively recruited. Before April 2017, the patients were treated with conventional care; all patients were treated with the ERAS pathway thereafter. The primary outcome was the postoperative length of hospital stay (LOS). The secondary outcomes were hospitalization costs and postoperative complications. Results In total, 138 patients were treated with the ERAS pathway, and the remaining patients underwent conventional care. The postoperative LOS was significantly shorter in the ERAS group than in the conventional group (median, 6 vs. 8 days). The hospitalization costs were also significantly lower in the ERAS group ($4086 vs. $5530). Ten (6.1%) patients in the ERAS group and 17 (12.3%) patients in the conventional group developed postoperative complications. The multivariable analysis showed that ERAS care was a significant independent predictive factor for a shortened LOS and reduced hospitalization costs. Conclusions The ERAS pathway was associated with a shortened LOS and reduced hospitalization costs for patients undergoing minimally invasive radical prostatectomy.


2021 ◽  
Author(s):  
Shu Wang ◽  
Jie Fan ◽  
Chunyan Hu ◽  
Tao Wu ◽  
Yuan Liu ◽  
...  

Abstract Objective The purpose of this study is to evaluate the association and predictive value of geriatric nutritional risk index (GNRI) in elderly patients with prostate cancer(PCa) undergoing laparoscopic radical prostatectomy (LRP). Methods the clinical data of 72 elderly patients (aged ≥ 65 y) with PCa undergoing LRP in the Department of Urology, Affiliated Hospital of North Sichuan Medical College from January 2018 to December 2020 were retrospectively analyzed. The basic information, laboratory examination indexes, operation conditions, postoperative complications and postoperative recovery indexes of patients were included. Clavien-Dindo Classification System (CDCS) was used to assess the postoperative complications. T-test was used to analyze the grouping variables. ROC curve was drawn to study the predictive value of GNRI for postoperative complications. Results The body weight, BMI, preoperative HGB, ALB values of malnutrition group (MNg) and normal nutrition group (NNg) were significantly positively correlated (P༜0.01); the incidence and severity of postoperative complications of MNg were significantly higher than those of NNg (P༜0.05). The average hospitalization costs of MNg was higher, the duration of postanesthesia care unit (PACU), duration of antibiotic use was longer and the duration of indwelling drainage tube were longer than NNg (P༜0.05). The volume of indwelling drainage tube were more than NNg (P༜0.05). Conclusion GNRI is an effective and reliable tool to evaluate preoperative nutritional status of prostate cancer, which is closely related to postoperative recovery and complications,and has predictive value.


2018 ◽  
Vol 122 (5) ◽  
pp. 801-807 ◽  
Author(s):  
Raisa S. Pompe ◽  
Burkhard Beyer ◽  
Alexander Haese ◽  
Felix Preisser ◽  
Uwe Michl ◽  
...  

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