A Systematic Review and Meta-Analysis of Pelvic Drain Insertion After Robot-Assisted Radical Prostatectomy

Zhong, Wenjie; Roberts, Matthew J.; Saad, Jeremy; Thangasamy, Isaac; Arianayagam, Ranjan; Sathianathen, Niranjan; Gendy, Rasha; Goolam, Ahmed; Khadra, Mohamed; Arianayagam, Mohan; Varol, Celi; Ko, Raymond; Canagasingham, Bertram; Ferguson, Richard; Winter, Matthew

doi:10.1089/end.2019.0554

Cited by 14 publications

(6 citation statements)

References 43 publications

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“…Although PDs are placed to prevent lymphoceles, their absence did not predict asymptomatic lymphocele development two weeks after surgery in this study. A previous systematic review and meta-analysis reported that PD placement after RARP with extended pelvic lymph node dissection does not prevent symptomatic lymphocele or postoperative complications (24), which also suggests that PD placement after RARP is not required. However, PD placement cannot be deemed unnecessary in all cases.…”

Section: Discussionmentioning

confidence: 97%

Examination of Necessity for Pelvic Drain Placement After Robot-assisted Radical Prostatectomy

Iwamoto

Kadono

Nakagawa

et al. 2021

In Vivo

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Background/Aim: Pelvic drain (PD) placement is commonly performed after robot-assisted radical prostatectomy (RARP), but the need for PD placement is unclear. This study aimed to assess the need for PD placement after RARP. Patients and Methods: This retrospective study analysed the effect of PD placement on postoperative complications in patients who underwent RARP between 2009 and 2018. All patients prior to October 1, 2016 had a PD placed; those after did not. Results: Of the 308 study patients, 231 received a PD (PD group) and 77 did not (ND group). The incidence of ileus, urinary tract infection and anastomotic leak did not differ significantly between the groups; nor did the incidence of asymptomatic and symptomatic lymphocele at 2 weeks and 1 year after surgery. Multivariate analysis showed that lymph node dissection is a predictor of asymptomatic lymphocele development two weeks after surgery. Conclusion: PD placement is not necessary after RARP.Prostate cancer is the most common cancer and second leading cause of cancer-related mortality in men (1). Most prostate cancers are diagnosed as localized prostate cancer (2, 3). Radical prostatectomy (RP) is the gold standard treatment for clinically localised prostate cancer (4). In addition to open 2895 This article is freely accessible online.

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Section: Discussionmentioning

confidence: 97%

Examination of Necessity for Pelvic Drain Placement After Robot-assisted Radical Prostatectomy

Iwamoto

Kadono

Nakagawa

et al. 2021

In Vivo

View full text Add to dashboard Cite

show abstract

“…Although PDs are placed to prevent lymphoceles, their absence did not predict asymptomatic lymphocele development two weeks after surgery in this study. A previous systematic review and meta-analysis reported that PD placement after RARP with extended pelvic lymph node dissection does not prevent symptomatic lymphocele or postoperative complications (25), which also suggests that PD placement after RARP is not required. However, PD placement cannot be deemed unnecessary in all cases.…”

Section: Discussionmentioning

confidence: 97%

Examination of necessity for pelvic drain placement after robot-assisted radical prostatectomy

Iwamoto

Kadono

Yaegashi

et al. 2021

Preprint

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PurposeRadical prostatectomy is the gold standard treatment for clinically localised prostate cancer. Pelvic drain (PD) placement is commonly performed after RARP to prevent the formation of urinary cysts, pelvic hematomas and lymphoceles that would require further treatment. RARP has been reported to have few perioperative complications, and the need for PD placement is not clear. This study aimed to assess the need for PD placement after robot-assisted radical prostatectomy (RARP). MethodThis retrospective uncontrolled before-after study analysed the effect of PD placement on postoperative complications in patients who underwent RARP between May 2009 and April 2018.ResultsAll patients prior to October 1, 2016 had a PD placed; those after did not. Of the 308 study patients, 231 received a PD (PD group) and 77 did not (ND group). The incidence of ileus, urinary tract infection and anastomotic leak did not differ significantly between the groups; nor did the incidence of asymptomatic and symptomatic lymphocele at 2 weeks and 1 year after surgery. Multivariate analysis showed that lymph node dissection is a predictor of asymptomatic lymphocele development two weeks after surgery.ConclusionPD placement is not necessary after RARP. Future large-scale studies are required to identify patients that would benefit from PD placement.

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“…Считалось, что методом профилактики является установка страховых дренажей. Однако в недавнем систематическом обзоре и метаанализе было продемонстрировано, что нет корреляции отсутствия страховых дренажей с формированием симптоматических ЛК после ТЛАЭ [14][15][16].…”

Section: таблица 2 клинико-патологическая характеристика двух группunclassified

Comparison of clips and electrosurgical instruments in sealing of lymphatic vessels during pelvic lymph node dissection at the time of radical cystectomy

et al. 2021

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Background. Bladder cancer is very common and real problem in oncourology. The main treatment for muscle invasive bladder cancer is radical cystectomy (RC). RC with pelvic lymph node dissection (PLND) may be associated with an increased risk of developing lymphatic complications such as lymphedema, prolonged lymphorrhea, and the formation of lymphocele.Objective: to compare the efficiency of clips and surgical instruments for preventing the development of lymphatic complications during PLND at the time of RC.Materials and methods. From January 2016 to October 2020 at the N.I. Pirogov Russian National Research Medical University on the basis of N.I. Pirogov City Clinical Hospital No. 1 were performed 60 RC with PLND. All patients were divided into two groups. The 1st group included patients who underwent the sealing of lymphatic vessels using titanium/polymer clips (n = 30). In the 2nd group the sealing was performed using ultrasonic/bipolar instruments (n = 30). All operations were performed by one surgeon. The study used univariate and multivariate logistic regression analysis.Results. The overall percentage of lymphatic complications was 29 (48.3 %) out of 60 patients. Out of them 7 (11.7 %) patients developed symptomatic lymphocele, and 3 (5.0 %) developed asymptomatic lymphocele, prolonged lymphorrhea was observed in 17 (28.3 %) patients, lymphedema of the lower extremities or genitals in 2 (3.3 %). The percentage of lymphatic complications in the 1st group was 66.7 % (n = 20), and in the 2nd group - 30.0 % (n = 9) (p = 0.004). In multivariate analysis the statistical significance was (p = 0.014), a high odds ratio (6.83; 95 % confidence interval 1.48-31.49) was observed with sealing of lymphatic vessels with clips, while a low odds ratio (0.14; 95 % confidence interval 0.03-0.67) was found with electrosurgical instruments.Conclusion. The use of ultrasonic or bipolar electrosurgical instruments can be an effective method for preventing the development of lymphatic complications during PLND at the time of RC.

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A Systematic Review and Meta-Analysis of Pelvic Drain Insertion After Robot-Assisted Radical Prostatectomy

Cited by 14 publications

References 43 publications

Examination of Necessity for Pelvic Drain Placement After Robot-assisted Radical Prostatectomy

Examination of Necessity for Pelvic Drain Placement After Robot-assisted Radical Prostatectomy

Examination of necessity for pelvic drain placement after robot-assisted radical prostatectomy

Comparison of clips and electrosurgical instruments in sealing of lymphatic vessels during pelvic lymph node dissection at the time of radical cystectomy

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