Comparison of Cognitive Function After Robot-Assisted Prostatectomy and Open Retropubic Radical Prostatectomy: A Prospective Observational Single-Center Study
| Autor: | Marlene Fischer, Cornelius Rademacher, Markus Graefen, Clara Holthusen, Christian Zöllner, Linnea Zins, Pierre Tennstedt, Alexander Haese, Stefanie Beck, Franziska von Breunig |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Supine position Urology medicine.medical_treatment Trendelenburg position 030232 urology & nephrology Neuropsychological Tests Single Center Head-Down Tilt 03 medical and health sciences Cognition 0302 clinical medicine Postoperative Cognitive Complications Robotic Surgical Procedures Germany Outcome Assessment Health Care medicine Humans Prospective Studies Prostatectomy medicine.diagnostic_test business.industry Incidence Neuropsychology Prostatic Neoplasms Neuropsychological test Middle Aged medicine.disease Surgery 030220 oncology & carcinogenesis business Postoperative cognitive dysfunction Neurocognitive |
| Zdroj: | Urology. 139:110-117 |
| ISSN: | 0090-4295 |
| Popis: | OBJECTIVE To assess the effects of robot-assisted radical prostatectomy in the Trendelenburg position on postoperative neurocognitive outcomes this study compared cognitive function between patients who underwent robot-assisted radical prostatectomy and those who underwent open retropubic radical prostatectomy. METHODS Objective evaluations of pre- and postoperative cognitive function were performed upon admission and before hospital discharge, by using a neuropsychological test battery. We collected self-reported data on cognitive failures at 3 months postoperatively. Binary logistic regression analysis was used to assess the effects of surgical technique on postoperative cognitive performance. RESULTS The pre- and postoperative neuropsychological assessments were completed by 367 patients with a median age of 64 years (range 44-76). The incidence of postoperative cognitive dysfunction was 23.9% after robot-assisted (39/165) and 22.3% after open radical prostatectomy (45/202). There was no significant difference in postoperative cognitive function during the early postoperative period (P = 0.758) and self-reported cognitive failures at 3 months (P = 0.303) between robot-assisted and open surgery. Surgical technique was not associated with early postoperative cognitive dysfunction in multivariable analysis (OR 1.012, 95%CI: 0.608-1.685, P = 0.962). CONCLUSION Compared with open surgery in supine position postoperative neurocognitive disorders do not occur more frequently after robot-assisted radical prostatectomy in the extreme Trendelenburg position. Based on these findings potential adverse effects on cognitive function do not have to be considered in the choice of surgical approach for radical prostatectomy. |
| Databáze: | OpenAIRE |
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