Abstract
ABSTRACTPurpose:To evaluate the influence of prior abdominal surgery on the outcomes after robotic-assisted laparoscopic radical prostatectomy (RALP).Materials and Methods:We retrospectively analyzed patients with prostate cancer who underwent RALP between June 2012 and February 2015 at our institution. Patients with prior abdominal surgery were compared with those without prior surgery while considering the mean total operating, console, and port-insertion times; mean estimated blood loss; positive surgical margin rate; mean duration of catheterization; and rate of complications.Results:A total of 203 patients who underwent RALP during the study period were included in this study. In all, 65 patients (32%) had a prior history of abdominal surgery, whereas 138 patients (68%) had no prior history. The total operating, console, and port-insertion times were 328 and 308 (P=0.06), 252 and 242 (P=0.28), and 22 and 17 minutes (P=0.01), respectively, for patients with prior and no prior surgery. The estimated blood losses, positive surgical margin rates, mean durations of catheterization, and complication rates were 197 and 170 mL (P=0.29), 26.2% and 20.2% (P=0.32), 7.1 and 6.8 days (P=0.74), and 12.3% and 8.7% (P=0.42), respectively. Furthermore, whether prior abdominal surgery was performed above or below the umbilicus or whether single or multiple surgeries were performed did not further affect the perioperative outcomes.Conclusions:Our results suggest that RALP can be performed safely in patients with prior abdominal surgery, without increasing the risk of complications.
Highlights
Radical prostatectomy is an effective treatment option for men with prostate cancer and currently offers the best long-term cancer control in patients with localized prostate cancer [1, 2]
Several studies have demonstrated that radical prostatectomy (RALP) has the advantages of decreased blood loss, lower perioperative complications, shorter length of hospital stay, and favorable oncologic outcomes [3, 4]
There were no significant differences among the baseline patient characteristics in terms of age, body mass index, preoperative prostate-specific antigen level, pathologic stage, pathologic Gleason score, and rate of pelvic lymphadenectomy between the two groups
Summary
Radical prostatectomy is an effective treatment option for men with prostate cancer and currently offers the best long-term cancer control in patients with localized prostate cancer [1, 2]. Robotic-assisted laparoscopic radical prostatectomy (RALP) has become rapidly widespread and firmly established as a standard treatment choice for localized prostate cancer. A previous report has demonstrated that prior abdominal surgery is a risk factor for increased surgical difficulty and complications during laparoscopic surgery [5]. Prior abdominal ibju | Impact of prior abdominal surgery on RALP surgery has been recognized as one of the most important risk factors of the outcomes of laparoscopic surgery, owing to the increased risk of bowel injury caused by the needle and trocar insertions. Little is known about the impact of prior abdominal surgery on the outcomes after RALP
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