Classification and Trends of Perioperative Morbidities Following Laparoscopic Radical Prostatectomy

Gonzalgo, M.L.; Pavlovich, Christian P.; Trock, Bruce J.; Link, Richard E.; Sullivan, Wendy; Su, Li Ming

doi:10.1097/01.ju.0000161607.04334.26

Cited by 99 publications

(47 citation statements)

References 18 publications

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“…During LRP, inadvertent injury to vessels usually occurs during trocar placement, during pelvic lymphadenectomy, or during instrument exchange. Although these types of injuries are rare in contemporary series, ranging from 0% to 1%, [30][31][32][33] recognition of vessel injury during surgery is very important. A theoretical advantage of minimally invasive surgery is decreased bleeding.…”

Section: Rectal Injurymentioning

confidence: 99%

Management of Complications of Prostate Cancer Treatment

Michaelson

Cotter

Gargollo

et al. 2008

CA: A Cancer Journal for Clinicians

163

146

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Section: Rectal Injurymentioning

confidence: 99%

Management of Complications of Prostate Cancer Treatment

Michaelson

Cotter

Gargollo

et al. 2008

CA: A Cancer Journal for Clinicians

163

146

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“…The results for operative time, blood loss, blood transfusion rates, hospital stay, and overall complication rates for RARP, LRP, and RRP are presented on Table 1, 16-36 , Table 2, 33,[37][38][39][40][41][42][43][44][45][46][47] and Table 3, 28,30,31,43,[48][49][50][51][52][53][54] respectively. The weighted means for operative time were 165 minutes (range 131-204 min) for RRP, 162.6 minutes (130-236 min) for the RARP series, and 205 minutes (100-266 min) for the LRP series.…”

Section: Perioperative Outcomesmentioning

confidence: 99%

Retropubic, Laparoscopic, and Robot-Assisted Radical Prostatectomy: A Critical Review of Outcomes Reported by High-Volume Centers

Coelho

Rocco

Patel

et al. 2010

Journal of Endourology

246

149

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Purpose: To critically review perioperative outcomes, positive surgical margin (PSM) rates, and functional outcomes of several large series of retropubic radical prostatectomy (RRP), laparoscopic RP (LRP), and robotassisted radical prostatectomy (RARP) currently available in the literature. Methods: A Medline database search was performed from November 1994 to May 2009, using medical subject heading search terms ''prostatectomy'' and ''Outcome Assessment (Health Care)'' and text words ''retropubic,'' ''robotic,'' and ''laparoscopic.'' Only studies with a sample size of 250 or more patients were considered. Weighted means were calculated for all outcomes using the number of patients included in each study as the weighing factor. Results: We identified 30 articles for RRP, 14 for LRP, and 14 for RARP. The mean intraoperative and postoperative RRP transfusion rates for RRP, LRP, and RARP were 20.1%, 3.5%, and 1.4%, respectively. The weighted mean postoperative complication rates for RRP, LRP, and RARP were 10.3% (4.8% to 26.9%), 10.98% (8.9 to 27.7%), and 10.3% (4.3% to 15.7%), respectively. RARP revealed a mean overall PSM rate of 13.6%, whereas LRP and RRP yielded a PSM of 21.3% and 24%, respectively. The weighted mean continence rates at 12 month follow-up for RRP, LRP, and RARP were 79%, 84.8%, and 92%, respectively. The weighted mean potency rates for patients who underwent unilateral or bilateral nerve sparing, at 12 month follow-up, were 43.1% and 60.6% for RRP, 31.1% and 54% for LRP, and 59.9% and 93.5% for RARP. Conclusion: RRP, LRP, and RARP performed in high-volume centers are safe options for treatment of patients with localized prostate cancer, presenting similar overall complication rates. LRP and RARP, however, are associated with decreased operative blood loss and decreased risk of transfusion when compared with RRP. Our analysis including high-volume centers also showed lower weighted mean PSM rates and higher continence and potency rates after RARP compared with RRP and LRP. However, the lack of randomized trials precludes definitive conclusions.

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“…Although CDCSC was used in several studies in the field of general surgery, in those related to urology was used only in retroperitonoscopy, laparoscopic radical prostatectomy and laparoscopic live donor nephrectomy (28,29,30). Attempting to classify the PCNL complications according to the CDCSC is based on the very near future.…”

Section: Discussionmentioning

confidence: 99%

“…The method is not completely innocent although overall success rate of >90%; it has been reported in the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study that 20.5% of 5724 subjects (n=1175) experienced one more complications (2,3). Although extravasation (7.2%), hemorrhage requiring blood transfusion (11.2-17.5%) and fever (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32).1%) are common complications; septicemia (0.3-4.7%), colon injuries (0.2-4.8%) and pleural injury (%0-3.1) are among the rare major complications (4). Conversion to open surgery is rare and is usually required during the first experience with PCNL (5).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Charlson’s Comorbidity Index on Clavien-Dindo Classification of Surgical Complications in Percutaneous Nephrolitotomy

Girgin¹,

Topaktaş²,

Altin³

et al. 2016

jus

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What's known on the subject? and What does the study add? ÖZ AmaçPerkütan nefrolitotomi (PNL), komorbiditesi olan hastalarda komplikasyonlara daha duyarlı olmaları nedeniyle zorludur. Bu çalışmada, kliniğimizde PNL operasyonları sonrası belirlenen komplikasyonlar üzerinde eşlik eden durumların etkisini hastaların yaşlarını da dikkate alarak dikkate alarak incelemeye çalıştık. gereç ve yöntemHaziran 2002 ve Haziran 2012 tarihleri arasında kliniğimizde, PNL uygulanan 360 hasta retrospektif olarak incelendi. Bu çalışmada hastalar, demografik özellikleri, akses giriş yerleri, yaşa göre düzeltilmiş Charlson Komorbidite İndeksi'ne (ACCI) göre preoperatif komorbiditeleri ve Clavien-Dindo Sınıflandırma Sistemi kullanılarak gelişen postoperatif komplikasyonları açısından değerlendirildi. BulgularÇalışmaya alınan 360 hastanın yaş ortalaması 46 idi (10-83 yıl). Hastaların 220'si (%61,1) erkek ve 140'ı (%38,9) kadındı. ACCI sınıflamasına göre hastaların 169'u (%46,9) grup 1 ve 191'i (%53,1) grup 2 olarak tanımlandı. Olguların 212'sine (%58,8) alt kaliks, 136'sına (37,7%) orta kaliks ve 12'sine (3,3%) de üst kaliks girişi uygulandı. Komplikasyonlara bakıldığında ACCI grup 1 hastalarda %12,4 sınıf 1, %18,9 sınıf 2, %8,28 sınıf 3a ve ACCI grup 2 hastalarda %6,8 sınıf 1, %26,7 sınıf 2, % 6,28 sınıf 3a komplikasyon görüldü (p=0,098; 0,16; 0,49). Sınıf 3b ve sınıf 4a komplikasyonlar sadece ACCI grup 2 hastalarda görüldü. Sınıf 4b ve 5 komplikasyon her iki grup hastalarda da görülmedi. objectivePercutaneous nephrolithotomy (PCNL) in comorbid patients is challenging due to the high susceptibility to complications. In our study, by taking the age of patents into account, we have tried to figure out the impact of comorbid conditions on complications identified after PCNL operations in our clinic. Materials and MethodsThree hundred-sixty patients, who underwent PCNL in our clinic between June 2002 and June 2012, were retrospectively analyzed. The patients were assessed in terms of demographic characteristics, access locations, preoperative comorbidity using the age-adjusted Charlson's Comorbidity Index (ACCI) and postoperative complications using the Clavien-Dindo classification of surgical complications. ResultsThe mean age of the patients was 46 (10-83) years. Two hundred-twenty (61.1%) patients were male and 140 (38.9%) were female. According to preoperative ACCI, 169 (46.9%) of the cases were classified as group 1 and 191 (53.1%) of the cases as group 2. In 212 (58.8%) patients, entry into the lower calyx, in 136 (37.7%) -into the middle calyx and in 12 (3.3%) patients, entry into the upper calyx was done. The rate of complications in ACCI group 1, grade 1, grade 2 and grade 3a was 12.4%, 18.9%, 8.28% and in group 2, it was 6.8%, 26.7%, 6.28%, respectively. There was no significant difference between the groups (p=0.098, p=0.16 and p=0.49, respectively). Grade 3b and grade 4a complications were seen only in In this series the remarkable feature is that about 50% of patients had various comorbidities. Advanced age and comor...

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Classification and Trends of Perioperative Morbidities Following Laparoscopic Radical Prostatectomy

Cited by 99 publications

References 18 publications

Management of Complications of Prostate Cancer Treatment

Management of Complications of Prostate Cancer Treatment

Retropubic, Laparoscopic, and Robot-Assisted Radical Prostatectomy: A Critical Review of Outcomes Reported by High-Volume Centers

The Effect of Charlson’s Comorbidity Index on Clavien-Dindo Classification of Surgical Complications in Percutaneous Nephrolitotomy

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