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- Title
Intraoperative intraocular pressure changes during robot-assisted radical prostatectomy: associations with perioperative and clinicopathological factors.
- Authors
Shirono, Yuko; Takizawa, Itsuhiro; Kasahara, Takashi; Maruyama, Ryo; Yamana, Kazutoshi; Tanikawa, Toshiki; Hara, Noboru; Sakaue, Yuta; Togano, Tetsuya; Nishiyama, Tsutomu; Fukuchi, Takeo; Tomita, Yoshihiko
- Abstract
<bold>Background: </bold>Steep Trendelenburg position (ST) during robot-assisted radical prostatectomy (RARP) poses a risk of increase in intraocular pressure (IOP) in men receiving robot-assisted radical prostatectomy (RARP). The aim of the study was to identify clinicopathological factors associated with increased IOP during RARP.<bold>Methods: </bold>We prospectively studied 59 consecutive prostate cancer patients without glaucoma. IOP was measured at 6 predefined time points before, during and after the operation (T1 to T6).<bold>Results: </bold>Compared with T1, IOP decreased after beginning of anesthesia(T2) (by - 6.5 mmHg, p < 0.05), and increased 1 h after induction of pneumoperitoneum in the steep Trendelenburg position (ST) (T3) (+ 7.3 mmHg, p < 0.05). IOP continued to increase until the end of ST (T4) (+ 10.2 mmHg, p < 0.05), and declined when the patient was returned to supine position under general anesthesia (T5) (T1: 20.0 and T5: 20.1 mmHg, p above 0.05). The console time affected the elevation of IOP in ST; IOP elevation during ST was more prominent in men with a console time of ≥4 h (n = 39) than in those with a console time of < 4 h (n = 19) (19.8 ± 6.3 and 15.4 ± 5.8 mmHg, respectively, p < 0.05). Of the 59 patients, 29 had a high baseline IOP (20.0 mmHg or higher), and their IOP elevated during ST was also reduced at T5 (T1: 22.6 and T5: 21.7 mmHg, p above 0.05). There were no postoperative ocular complications.<bold>Conclusions: </bold>Console time of < 4 h is important to prevent extreme elevation of IOP during RARP. Without long console time, RARP may be safely performed in those with relatively high baseline IOP.
- Subjects
INTRAOCULAR pressure; PROSTATECTOMY; TONOMETRY; SUPINE position; PROSTATE cancer patients; SURGICAL complications
- Publication
BMC Urology, 2020, Vol 20, Issue 1, p1
- ISSN
1471-2490
- Publication type
journal article
- DOI
10.1186/s12894-020-00595-5