PD43-05 PROSPECTIVE COMPARISON OF OPEN VERSUS ROBOT-ASSISTED RADICAL PROSTATECTOMY FOR CLINICALLY LOCALIZED PROSTATE CANCER: ANALYSIS OF 1806 CONSECUTIVE MEN TREATED IN A UNIVERSAL HEALTHCARE SYSTEM

Autor:	Howard Evans, Keith Rourke, Sunita Ghosh, Blair St. Martin, Niels Jacobsen, Eric Estey, David Mador, Michael P. Chetner, Derek Bochinski, Adrian Fairey, Michael G. Hobart, Lucas W. Dean
Rok vydání:	2016
Předmět:	medicine.medical_specialty Blood transfusion business.industry Genitourinary system Prostatectomy Urology medicine.medical_treatment Postoperative complication medicine.disease Logistic regression Surgery Dissection Prostate cancer medicine.anatomical_structure Medicine business Lymph node
Zdroj:	Journal of Urology. 195
ISSN:	1527-3792 0022-5347
DOI:	10.1016/j.juro.2016.02.1783
Popis:	characteristics consisted of age, Charlson Comorbidity Index, surgical approach (retropubic vs. robot-assisted vs. laparoscopic vs. perineal), status of lymph node dissection (LND) and nerve-sparing procedure, hospital district, hospital region and hospital volume. We examined the rate of blood transfusion, intraand postoperative complications, inhospital mortality, length of stay (LOS) and hospital charges using validated methodology. RESULTS: Overall, 25,333 men underwent RP. Of these, 16,372 (64.6%) men were treated by retropubic, 5,657 (22.3%) by robot-assisted, 2,730 (10.8%) by laparoscopic and 574 (2.3%) by perineal RP. The rate of LND and nerve-sparing procedure was 84.1 and 52.8%, respectively. The rate of autologous and allogeneic blood transfusion was 0.3 and 8.8%, respectively. Intraoperative complications were recorded in 2.7%. Specifically, rectal laceration, ureteral injury and nerveor vessel injury were recorded in 1.5, 0.7 and 1.1%, respectively. Postoperative complications were recorded in 26.7%. Specifically, 2.7% of patients suffered from cardial, 1.1% from respiratory, 4.0% from wound, 1.6% from vascular, 8.6% from genitourinary, 7.5% from miscellaneous medical and 13.2% from miscellanoeous surgical complications. In-hospital mortality was 0.2%. Mean LOS was 10.8 days. Mean hospital charges were 7,409 Euro. Results from multivariable logistic regression analyses will be presented at the congress. CONCLUSIONS: Institutional results should ideally be compared to nationally representative data. In 2012, RP in Germany was performed in 33% in a minimally-invasive fashion, the most temporal overall postoperative complication rate was 27%.
Databáze:	OpenAIRE
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