649 MINIMALLY INVASIVE RADICAL PROSTATECTOMY HOLD NO ADVANTAGE OVER OPEN RADICAL PROSTATECTOMY WITH REGARD TO COMPLICATION RATES: POPULATION-BASED DATA FROM THE UNITED STATES

Abstract

You have accessJournal of UrologyProstate Cancer: Localized1 Apr 2011649 MINIMALLY INVASIVE RADICAL PROSTATECTOMY HOLD NO ADVANTAGE OVER OPEN RADICAL PROSTATECTOMY WITH REGARD TO COMPLICATION RATES: POPULATION-BASED DATA FROM THE UNITED STATES Jan Schmitges, Firas Abdollah, Maxine Sun, Claudio Jeldres, Daniel Liberman, Orchidee Djahangirian, Felix K. Chun, Paul Perrotte, Francesco Montorsi, Alexander Haese, Markus Graefen, and Pierre I. Karakiewicz Jan SchmitgesJan Schmitges Hamburg, Germany More articles by this author , Firas AbdollahFiras Abdollah Milan, Italy More articles by this author , Maxine SunMaxine Sun Montreal, Canada More articles by this author , Claudio JeldresClaudio Jeldres Montreal, Canada More articles by this author , Daniel LibermanDaniel Liberman Montreal, Canada More articles by this author , Orchidee DjahangirianOrchidee Djahangirian Montreal, Canada More articles by this author , Felix K. ChunFelix K. Chun Hamburg, Germany More articles by this author , Paul PerrottePaul Perrotte Montreal, Canada More articles by this author , Francesco MontorsiFrancesco Montorsi Milan, Italy More articles by this author , Alexander HaeseAlexander Haese Hamburg, Germany More articles by this author , Markus GraefenMarkus Graefen Hamburg, Germany More articles by this author , and Pierre I. KarakiewiczPierre I. Karakiewicz Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1565AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To date, studies suggest a benefit of minimally invasive radical prostatectomy (MIRP) over open radical prostatectomy (ORP) when complication rates are compared. We examined intraoperative and in-hospital complication rates as well as blood transfusion rates after either MIRP or ORP within a contemporary population-based sample from the United States. METHODS Within the Health Care Utilization Project Nationwide Inpatient Sample (NIS) we focused on patients in whom radical prostatectomies were performed between 2001 and 2007. We relied on previously validated methodology to quantify rates, trends and in-hospital morbidity and transfusion rates. Univariable and multivariable logistic regression analyses were used. Adjustment was made for age, race, baseline Charlson Comorbidity Index (CCI), annual hospital volume tertiles (AHV) and hospital academic status. RESULTS A total of 89970 radical prostatectomies were performed during the study period. Of those, 4389 were MIRPS (4.9%). The intraoperative complication rate was 1.3% for MIRP vs. 1.4% for ORP (p=0.8). The overall in-hospital complication rates were 9.9 vs. 11.4%, respectively (p=0.003). Blood transfusion rates were 1.8 and 6.5% for MIRP and ORP (p<0.001). In multivariable analyses, relative to ORP, MIRP was not associated with lower rates of intraoperative (odds ratio [OR]: 1.1, p=0.6) and in-hospital complications (OR: 1.1, p=0.1). Conversely, MIRP exerted a protective effect on homologous blood transfusion rate (OR: 0.41, p<0.001). CONCLUSIONS Despite the existence of reports suggesting more favourable complication outcomes after MIRP relative to ORP, our national population-based sample failed to show a benefit of MIRP when complications were defined as the main outcome. Conversely, fewer transfusions were recorded in MIRP patients. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e263 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jan Schmitges Hamburg, Germany More articles by this author Firas Abdollah Milan, Italy More articles by this author Maxine Sun Montreal, Canada More articles by this author Claudio Jeldres Montreal, Canada More articles by this author Daniel Liberman Montreal, Canada More articles by this author Orchidee Djahangirian Montreal, Canada More articles by this author Felix K. Chun Hamburg, Germany More articles by this author Paul Perrotte Montreal, Canada More articles by this author Francesco Montorsi Milan, Italy More articles by this author Alexander Haese Hamburg, Germany More articles by this author Markus Graefen Hamburg, Germany More articles by this author Pierre I. Karakiewicz Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...