LOW-PRESSURE PNEUMOPERITONEUM WITH ABDOMINAL ELEVATION IN LAPAROSCOPIC RADICAL PROSTATECTOMY IN ELDERLY PATIENTS WITH A LOCALIZED FORM OF PROSTATE CANCER

2021 ◽  
pp. 934-939
Author(s):  
Б. К. Комяков ◽  
Е. В. Колыгина ◽  
Е. С. Невирович ◽  
А. Н. Селиванов ◽  
И. В. Телегин
Keyword(s):  
Prostate Cancer ◽  
Postoperative Complications ◽  
Radical Prostatectomy ◽  
Elderly Patients ◽  
Abdominal Wall ◽  
Anterior Abdominal Wall ◽  
Low Pressure ◽  
Laparoscopic Radical Prostatectomy ◽  
Actual Problem ◽  
Localized Form

Рак предстательной железы является актуальной проблемой у мужчин старших возрастных групп, при этом сопутствующий преморбидный фон данной категории пациентов зачастую приводит к развитию послеоперационных осложнений при применении стандартного оперативного метода. В статье приведены результаты применения пневмоперитонеума низкого давления с лифтингом передней брюшной стенки при лапароскопической радикальной простатэктомии у пациентов пожилого возраста с локализованной формой рака предстательной железы. Убедительно показано, что использование этой методики позволяет обеспечить удовлетворительное операционное поле, получить стабильные показатели операционного мониторинга и при этом уменьшить длительность самого оперативного пособия, а также уменьшить длительность госпитализации и частоту встречаемости послеоперационных осложнений. Prostate cancer is an actual problem among males of older age groups, while the concomitant pre-morbid background of this category of patients often leads to the development of postoperative complications using the standard surgical method. The article presents the results of using low-pressure pneumoperitoneum with anterior abdominal wall lifting for laparoscopic radical prostatectomy in elderly patients with a localized form of prostate cancer. Convincingly shown that the use of low-pressure techniques pneumoperitoneum with lifting anterior abdominal wall ensures satisfactory operating field, obtains stable indicators of operational monitoring and allow to reduce the duration of the operation, as well as reduce the duration of hospitalization and incidence of postoperative complications.

scholarly journals Preoperative Nutritional Evaluation of Elderly Patients with Prostate Cancer Undergoing Laparoscopic Radical Prostatectomy

2021 ◽  
Author(s):  
Shu Wang ◽  
Jie Fan ◽  
Chunyan Hu ◽  
Tao Wu ◽  
Yuan Liu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Postoperative Complications ◽  
Radical Prostatectomy ◽  
Elderly Patients ◽  
Predictive Value ◽  
Postoperative Recovery ◽  
Laparoscopic Radical Prostatectomy ◽  
Drainage Tube ◽  
Postanesthesia Care Unit ◽  
Nutritional Risk Index

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.

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.

214: Incidence and Risk Factors of Symptomatic DVT in Prostate Cancer Patients Undergoing Laparoscopic Radical Prostatectomy

2006 ◽  
Vol 175 (4S) ◽  
pp. 70-71
Author(s):  
Fernando P. Secin ◽  
Clément-Claude Abbou ◽  
Inderbir S. Gill ◽  
Georges Fournier ◽  
Thierry Piéchaud ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Laparoscopic Radical Prostatectomy

scholarly journals Comparison of functional and oncological outcomes of innovative “three-port” and traditional “four-port” laparoscopic radical prostatectomy in patients with prostate cancer

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ben Xu ◽  
Si-da Cheng ◽  
Yi-ji Peng ◽  
Qian Zhang
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Laparoscopic Radical Prostatectomy ◽  
Positive Surgical Margin ◽  
Oncological Outcomes ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background To compare the functional and oncological outcomes between innovative “three-port” and traditional “four-port” laparoscopic radical prostatectomy (LRP) in patients with prostate cancer (PCa). Methods We retrospectively collected the data of PCa patients treated at our institutions from June 2012 to May 2016. According to the inclusion criteria, a total of 234 patients were included in the study, including 112 in group A (four-port) and 122 in group B (three-port). The perioperatively surgical characteristics, functional and oncological outcomes were compared between groups. Results There were no statistical differences in the baseline parameters between these two groups. Compared with group A, the operative time (OT) and estimated blood loss (EBL) were significantly less in group B. On follow-up, the rate of positive surgical margin (PSM), prostate specific antigen (PSA) biochemical recurrence and continence after LRP did not show any statistically significant difference between the groups. An identical conclusion was also received in comparison of overall survival (OS) and biochemical recurrence-free survival (BRFS) between both groups. Conclusions Innovative “three-port” LRP can significantly shorten the OT and reduce the EBL compared with the traditional “four-port” LRP. Meanwhile, it does not increase the rate of PSM and PSA biochemical recurrence. “Three-port” LRP could be popularized in the future in view of its superior surgical technique, considerably better functional outcomes and remarkable oncological control.

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.

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