MP15-05 PREOPERATIVE PARAMETERS TO PREDICT THE DEVELOPMENT OF SYMPTOMATIC LYMPHOCELES AFTER RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I (MP15)1 Sep 2021MP15-05 PREOPERATIVE PARAMETERS TO PREDICT THE DEVELOPMENT OF SYMPTOMATIC LYMPHOCELES AFTER RADICAL PROSTATECTOMY Samy Mahjoub, Marius Hennecken, David Pfister, Florian H. Hartmann, Patricia John, Maximilian Schmautz, and Axel Heidenreich Samy MahjoubSamy Mahjoub More articles by this author , Marius HenneckenMarius Hennecken More articles by this author , David PfisterDavid Pfister More articles by this author , Florian H. HartmannFlorian H. Hartmann More articles by this author , Patricia JohnPatricia John More articles by this author , Maximilian SchmautzMaximilian Schmautz More articles by this author , and Axel HeidenreichAxel Heidenreich More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001996.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To investigate, if preoperative parameters exist for the development of symptomatic lymphoceles (SL) after radical prostatectomy (RP) and pelvic lymph node dissection (PLND) and thereby to optimize the therapeutic regimen by modifying the surgical technique for these patients. METHODS: Pre- and postoperative clinical and pathological data of 592 patients who underwent RP and PLND were retrospectively evaluated. Included parameters were age, BMI, PSA, PSA ratio, PSA density, number of resected and/or positive lymph nodes, previous abdominal surgery, previous pelvic radiotherapy, previous anticoagulation and surgical approach. The statistical analysis was performed by binary logistic regression. RESULTS: 59 patients (10%) developed an SL, of which 57 underwent open retropubic prostatectomy (RRP) and 2 underwent robot-assisted radical prostatectomy (RARP). Multivariate logistic regression revealed the following parameters as statistically significant independent risk factors: PSA (Odds Ratio [OR]=2.23, 95% CI [1.25; 5.04], p=0.04), number of resected lymph nodes (OR=1.47, 95% CI [1.10; 1.97], p<0.01), previous abdominal surgery (OR=2.58, 95% CI [1.38; 4.91], p<0.01) and surgical approach (OR=0.08, 95% CI [0.01; 0.27], p<0.01). Previous anticoagulation with warfarin or NOACs almost showed statistically significant results (OR=2.39, 95% CI [0.92; 5.51], p=0.05). CONCLUSIONS: The risk for SL formations might be predictable considering preoperative risk factors such as PSA, previous abdominal surgery and anticoagulation. The surgical approach represented a significant risk so that RARP should be the procedure of choice if possible. If RRP is considered, patients at increased risk for SL may benefit from peritoneal fenestration during RP to reduce the postoperative complications. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e265-e265 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Samy Mahjoub More articles by this author Marius Hennecken More articles by this author David Pfister More articles by this author Florian H. Hartmann More articles by this author Patricia John More articles by this author Maximilian Schmautz More articles by this author Axel Heidenreich More articles by this author Expand All Advertisement Loading ...