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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.
- Source :
-
Journal of robotic surgery [J Robot Surg] 2022 Feb; Vol. 16 (1), pp. 45-52. Date of Electronic Publication: 2021 Feb 09. - Publication Year :
- 2022
-
Abstract
- To 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.<br /> (© 2021. The Author(s).)
- Subjects :
- Humans
Male
Postoperative Complications epidemiology
Postoperative Complications etiology
Postoperative Complications surgery
Prostatectomy adverse effects
Referral and Consultation
Retrospective Studies
Tertiary Care Centers
Treatment Outcome
Prostatic Neoplasms complications
Prostatic Neoplasms surgery
Robotic Surgical Procedures methods
Robotics
Subjects
Details
- Language :
- English
- ISSN :
- 1863-2491
- Volume :
- 16
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of robotic surgery
- Publication Type :
- Academic Journal
- Accession number :
- 33559802
- Full Text :
- https://doi.org/10.1007/s11701-021-01192-w