Perioperative morbidity of laparoscopic radical prostatectomy compared with open radical retropubic prostatectomy
| Autor: | Leonard G. Gomella, Christopher Garlitz, David E. McGinnis, Stephen E. Strup, James A. Brown, Stuart M. Diamond |
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| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Laparoscopic radical prostatectomy Ileus Urology medicine.medical_treatment Blood Loss Surgical Anastomosis Cohort Studies Hemoglobins medicine Humans Blood Transfusion Intraoperative Complications Neoplasm Staging Retrospective Studies Prostatectomy business.industry Prostate Prostatic Neoplasms Perioperative Length of Stay Middle Aged Prostate-Specific Antigen medicine.disease Surgery Neck of urinary bladder Oncology Creatinine Laparoscopy lipids (amino acids peptides and proteins) Morbidity business Complication Radical retropubic prostatectomy |
| Zdroj: | Urologic Oncology: Seminars and Original Investigations. 22:102-106 |
| ISSN: | 1078-1439 |
| DOI: | 10.1016/s1078-1439(03)00101-7 |
| Popis: | The objective of the study was to compare the perioperative complication rates of our initial 60 laparoscopic radical prostatectomy (LRP) patients and our most recent 60 sequential open radical retropubic prostatectomy (RRP) patients. Sixty sequential LRP and 60 sequential RRP patients treated between March 2000 and March 2002 were retrospectively evaluated. Patients who received neo-adjuvant hormonal therapy or had metastatic disease and 3 LRP patients converted to open RRP were excluded. Estimated blood loss (EBL), transfusion rates, hemoglobin level, serum and drain fluid creatinine levels, hospital stay and complication rates were analyzed. There were 15 (25%) and 11 (18.3%) complications in the LRP and RRP cohorts, respectively. There were 3 (ulnar neuropathy, ureteral stricture, anastomotic leak with ureteral obstruction requiring reoperation), and 4 [2 bladder neck contractures (BNC) and 2 deep venous thromboses (DVT)] major complications, respectively. Minor complications included rectus hematoma, superficial wound infections, ileus and anastomotic urine leaks. A higher incidence of the latter (10 patients) was noted in the LRP cohort. One (1.7%) LRP and 31 (52%) RRP cohort patients received intraoperative or postoperative transfusions. The mean (median) EBL was 317 (250) and 1355 (1100) for the LRP and RRP cohorts, respectively. A transient, insignificant increase in serum creatinine from a median of 1.0 to 1.2 mg/dL was observed only in the LRP cohort. We concluded that our initial 60 LRP patients had a similar, but not improved, rate of perioperative complications when compared with 60 sequential open RRP patients of nearly identical age, preoperative PSA and prostate size. The types of complications differed between the LRP and RRP cohorts. |
| Databáze: | OpenAIRE |
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