scholarly journals Morbid obesity is adversely associated with perioperative outcomes in patients undergoing robot-assisted laparoscopic radical prostatectomy

2020 ◽  
Vol 14 (11) ◽  
Author(s):  
Hedong Han ◽  
Yingyi Qin ◽  
Yiming Ruan ◽  
Jia He ◽  
Zhexu Cao ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Postoperative Complications ◽  
Radical Prostatectomy ◽  
Propensity Score ◽  
Laparoscopic Radical Prostatectomy ◽  
Class I ◽  
Perioperative Outcomes ◽  
Robot Assisted ◽  
Obesity Class ◽  
Propensity Score Weighting

Introduction: Robot-assisted laparoscopic radical prostatectomy (RALRP) may be more challenging in obese individuals. This study aimed to evaluate whether obesity had an adverse effect on perioperative outcomes following RALRP. Methods: Hospitalized patients who underwent RALRP from 2008–2014 were identified using the National Inpatient Sample database. We grouped RALRP patients into non-obese, obesity class I–II and obesity class III (morbid obesity). Rates of blood transfusion, intraoperative and postoperative complications, in-hospital mortality, prolonged length of stay, and total costs were compared among the three groups by univariate regression, multivariate regression, and propensity score weighting analysis. Results: Of 53 301 patients identified, 48 725 were non-obese, 3572 were diagnosed with obesity class I–II, and 1004 were diagnosed with morbid obesity. Compared to non-obesity (7.62%), overall postoperative complications were commonly observed in obesity class I–II (10.55%) and morbid obesity (17.11%). Multivariable analyses suggested that morbid obesity was associated with increased overall postoperative (odds ratio [OR] 2.00; 95% confidence interval [CI] 1.65–2.42), cardiac (OR 1.63; 95% CI 1.03–2.58), respiratory (OR 4.03; 95% CI 3.04–5.36), genitourinary (OR 1.77; 95% CI 1.08–2.90), miscellaneous medical (OR 1.94; 95% CI 1.58–2.39) complications, prolonged hospitalization (OR 1.86; 95% CI 1.57–2.21), and 12% higher total cost. Propensity score weighting analysis yielded similar results. Adequate covariate balance was achieved for all variables after weighting. Conclusions: Morbid obesity is adversely associated with perioperative outcomes in RALRP. Close management is required in patients undergoing RALRP with morbid obesity for potential worse prognosis.

Robot-Assisted Laparoscopic Radical Prostatectomy: Perioperative Outcomes of 1500 Cases

2008 ◽  
Vol 22 (10) ◽  
pp. 2299-2306 ◽  
Author(s):  
Vipul R. Patel ◽  
Kenneth J. Palmer ◽  
Geoff Coughlin ◽  
Srinivas Samavedi
Keyword(s):  
Radical Prostatectomy ◽  
Laparoscopic Radical Prostatectomy ◽  
Perioperative Outcomes ◽  
Robot Assisted

Postoperative complications of contemporary open and robot-assisted laparoscopic radical prostatectomy using standardised reporting systems

2018 ◽  
Vol 122 (5) ◽  
pp. 801-807 ◽  
Author(s):  
Raisa S. Pompe ◽  
Burkhard Beyer ◽  
Alexander Haese ◽  
Felix Preisser ◽  
Uwe Michl ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Radical Prostatectomy ◽  
Laparoscopic Radical Prostatectomy ◽  
Robot Assisted ◽  
Reporting Systems

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.

scholarly journals Robot-Assisted vs. Laparoscopic Radical Prostatectomy for Immediate- and High-Risk Localized Prostate Cancer: A Propensity-Score Matched Analysis

2021 ◽  
Author(s):  
Deng Wen ◽  
Zhang Cheng ◽  
Jiang Hao ◽  
Li Yulei ◽  
Liu Xiaoqiang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
Propensity Score ◽  
Lower Risk ◽  
Laparoscopic Radical Prostatectomy ◽  
Localized Prostate Cancer ◽  
Robot Assisted ◽  
Grade Ii

Abstract Background To evaluate the functional and oncological efficacy of robot-assisted radical prostatectomy (RARP) and laparoscopic radical prostatectomy (LRP) for immediate- and high-risk localized prostate cancer (PCa). Methods 232 patients bearing immediate- and high-risk localized PCa between January 2016 and October 2019 were enrolled according to the inclusion criteria. The perioperative, functional and oncological outcomes were compared between the RARP and LRP groups after applying the propensity-score matching (PM) (1:1) method, which were employed to attenuate the impact of the potential baseline confounders. Results In all, except for 10 patients without a suitable pair, the remaining patients in the LRP group were successfully matched to 85 patients in the RARP arm. All differences in preoperative variables turned to be insignificant after PM. Within the matched cohort, no open conversion was required in both groups. The RARP group was corrected with a significantly shorter mean operative time than the LRP group (p < 0.001). Patients in the RARP arm were also at a lower risk of ≤ Grade II complications than those in the LRP group (p = 0.036). Meanwhile, the proportions of transfusion and ≥ Grade II complications in the RARP group were similar to that in the LRP group (p = 0.192 and p = 1.000, respectively). No significant differences regarding the mean estimated blood loss, rates of pT3 disease and positive surgical margin, median specimen Gleason score and hospital stay length existed between the two groups. RARP vs. LRP tended to a significantly higher percentage of urinary continence at the removal of catheter (p = 0.031), postoperative 6 months (p = 0.043), and last follow-up (p = 0.046). Significant differences were also found between the RARP and LRP arms in erectile function at postoperative 6 months and last follow-up (p = 0.013 and p = 0.009, respectively). The statistical comparability between the two groups was observed in biochemical recurrence-free survival (p = 0.228). Conclusions For surgically managing immediate- and high-risk localized PCa, RARP tended to a lower risk of ≤ Grade II complications and superior functional preservation without cancer control being compromised when comparing with LRP.

scholarly journals A comparison of the da Vinci Xi vs. da Vinci Si surgical systems for radical prostatectomy

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kun-Yang Lei ◽  
Wen-Jie Xie ◽  
Sheng-Qiang Fu ◽  
Ming Ma ◽  
Ting Sun
Keyword(s):  
Radical Prostatectomy ◽  
Da Vinci ◽  
Laparoscopic Radical Prostatectomy ◽  
Perioperative Outcomes ◽  
Da Vinci Xi ◽  
Robot Assisted ◽  
Short Term ◽  
Term Efficacy ◽  
Da Vinci Si ◽  
The Cost

Abstract Background To compare the perioperative and short-term efficacy and cost of the da Vinci Xi and da Vinci Si surgical systems for radical prostatectomy. Methods We retrospectively analyzed the clinical data of 175 patients with prostate cancer who underwent radical prostatectomy with the da Vinci Si or Xi surgical systems in our hospital from June 2019 to June 2020. Of the 175 patients, 82 underwent robot-assisted laparoscopic radical prostatectomy with the da Vinci Xi surgery system, and 93 patients underwent robot-assisted laparoscopic radical prostatectomy with the da Vinci Si surgical system. The perioperative outcomes, short-term efficacy and costs were compared between the two groups. Results The anesthesia time, operation time, docking time, indwelling catheter time and postoperative bed rest time in the Xi group were shorter than those in the Si group (respectively, 268.8 min vs. 219.3 min, P = 0.001; 228.2 min vs. 259.6 min, P < 0.001; 7.4 min vs. 12.7 min, P < 0.001; 8.6 d vs. 9.7 d, P = 0.036; 2.2 d vs. 2.6 d, P = 0.002). However, the total cost of hospitalization and the cost of intraoperative consumables in the Xi group were higher than those in the Si group (84,740.7 vs. 76,739.1 ¥, P = 0.003; 13,199.4 vs. 10,823.0 ¥, P = 0.019). Conclusions Although the cost of robot-assisted radical prostatectomy is higher, compared with the Si system, the Xi system has better perioperative outcomes and can provide similar short-term efficacy and oncology outcomes.

scholarly journals Perioperative outcomes of robot-assisted laparoscopic radical prostatectomy (RALRP) and LRP in patients with prostate cancer based on risk groups

2020 ◽  
Vol 18 (3) ◽  
pp. 187-193
Author(s):  
Napat Amornratananont ◽  
Kun Sirisopana ◽  
Suchin Worawichawong ◽  
Panas Chalermsanyakorn ◽  
Premsant Sangkum ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Risk Groups ◽  
Laparoscopic Radical Prostatectomy ◽  
Perioperative Outcomes ◽  
Robot Assisted
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