The impact of extended pelvic lymph node dissection on the risk of hospital readmission within 180 days after robot assisted radical prostatectomy.

Autor: Sebben, Marco, Tafuri, Alessandro, Shakir, Aliasger, Pirozzi, Marco, Processali, Tania, Rizzetto, Riccardo, Amigoni, Nelia, Tiso, Leone, De Michele, Mario, Panunzio, Andrea, Cerrato, Clara, Brunelli, Matteo, Migliorini, Filippo, Novella, Giovanni, De Marco, Vincenzo, Siracusano, Salvatore, Artibani, Walter, Porcaro, Antonio Benito
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Zdroj: World Journal of Urology; Nov2020, Vol. 38 Issue 11, p2799-2809, 11p
Abstrakt: Objective: To evaluate the factors associated with the risk of hospital readmission after robot assisted radical prostatectomy (RARP) with or without extended pelvic lymph node dissection (ePLND) for prostate cancer (PCA) over a long term. Materials and methods: The risk of readmission was evaluated by clinical, pathological, and perioperative factors. Skilled and experienced surgeons performed the procedures. Patients were followed for complications and hospital readmission for a period of six months. The logistic regression model and Cox's proportional hazards assessed the association of factors with the risk of readmission. Results: From January 2013 to December 2018, 890 patients underwent RARP; ePLND was performed in 495 of these patients. Hospital readmission was detected in 25 cases (2.8%); moreover, it was more frequent when RARP was performed with ePLND (4.4% of cases) than without (0.8% of patients). On the final multivariate model, ePLND was the only independent factor that was positively associated with the risk of hospital readmission (hazard ratio, HR = 5935; 95%CI 1777–19,831; p = 0.004). Conclusions: Over the long term after RARP for PCA, the risk of hospital readmission is associated with ePLND. In patients who underwent RARP and ePLND, 4.4% of them had a readmission, compared to RARP alone, in which only 0.8% of cases had a readmission. When ePLND is planned for staging pelvic lymph nodes, patients should be informed of the increased risk of hospital readmission. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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