Factors influencing unplanned re-operation of prostatic cancer and its countermeasures

Abstract

Objective To analyze the main causes for unplanned re-operation of prostatic cancer. Methods The clinical data of 4 patients with prostatic cancer who underwent an unplanned re-operation were analyzed retrospectively between September 2014 and July 2019 in our hospital.Preoperative data of patients was collected as follows: mean age of 65 years, ranged from 56 to 71 years.tPSA ranged from 5.17-13.20 ng/ml.Gleason score of 3+ 3 in 1 case, 3+ 4 in 2 cases, 4+ 4 in 1 case. pTNM pT2a in 2 Cases, pT2b in 2 cases. LRP(extraperitoneal approach) in 1 case, RARP(transperitoneal approach) in 3 cases. Results The main causes for unplanned re-operation were as follows: perioperative hemodynamic instability(75%, 3/4), post-operative fever(25%, 1/4). All 4 re-operations were performed by urologists using Laparoscopic exploration of abdomen. Conclusions Inadequate and inappropriate surgical hemostasis are the key to lead a second-look surgery of prostatic cancer.A complete hemostasis could help to lower the re-operation rate.Laparoscopic exploration of abdomen could be one of the choices to deal with re-operation after minimally invasive radical prostatectomy. Key words: Prostatic neoplasms; Prostatectomy; Minimally invasive; Unplanned re-operation; Complications