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- Title
Complications following robot-assisted radical prostatectomy in a prospective Canadian cohort of 305 consecutive cases.
- Authors
Fuller, Andrew; Pautler, Stephen E.
- Abstract
Background: Robot-assisted radical prostatectomy (RARP) has emerged in the last decade as an alternative to open radical prosta-tectomy for men with localized prostate cancer. The increased cost of this technique has been justified by its ability to reduce blood loss, and to provide improved vision, less postoperative pain and more rapid recovery from surgery, while maintaining satisfactory oncological and functional outcomes. Given the increasing diffu-sion of robotic surgical technology within Canada and its associ-ated high capital and operating costs, we review the clinical out-comes and complications from 305 consecutive cases performed at our Canadian institution. Methods: A consecutive cohort of 305 patients with a mean follow-up of 30 months was analyzed with institutional ethics approval. All patients were treated and reviewed postoperatively by a sin-gle surgeon (SP). The primary aim of the study was to assess the incidence and type of complications associated with RARP in a Canadian setting. Our prospective database captured preoperative, intra-operative and postoperative data and was maintained by an individual independent of the robotic program. We report com-plications categorized according to the Clavien system. Multiple complications seen in an individual were recorded separately for the purposes of our analysis. Results: Between April 2005 and October 2010, 305 patients underwent RARP at our institution. A total of 70 complications were identified, with 47 (67.1%) requiring only conservative or pharmacological management (Clavien l-ll). Twenty-three patients were found to have a major complication (Clavien lll-V). Of the 1 6 who required intervention under general anesthesia, 3 required emergency treatment and the remaining patients underwent elec-tive surgery. Conclusions: RARP has been incorporated at our institution with an acceptably low rate of intra-operative and postoperative complica-tions. We have found that the database was effective in providing patients with outcome-related information, which in turn helped us gain patient consent with regard to the institution-specific risks of RARP.
- Subjects
PROSTATECTOMY; SURGICAL robots; SURGICAL complications; COHORT analysis; PROSTATE cancer; CANCER in men
- Publication
Canadian Urological Association Journal, 2013, Vol 7, Issue 3/4, p116
- ISSN
1911-6470
- Publication type
Article
- DOI
10.5489/cuaj.818