MP69-11 MINIMALLY INVASIVE VS. OPEN RADICAL PROSTATECTOMY: AN ANALYSIS OF 30-DAY POSTOPERATIVE COMPLICATIONS, UNPLANNED READMISSIONS, AND MORTALITY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy V1 Apr 2016MP69-11 MINIMALLY INVASIVE VS. OPEN RADICAL PROSTATECTOMY: AN ANALYSIS OF 30-DAY POSTOPERATIVE COMPLICATIONS, UNPLANNED READMISSIONS, AND MORTALITY Christian Meyer, Akshay Sood, Firas Abdollah, Jesse Sammon, Malte Vetterlein, Björn Löppenberg, Julian Hanske, Jeffrey Leow, Alexander Cole, Adam Kibel, Maxine Sun, Mani Menon, and Quoc-Dien Trinh Christian MeyerChristian Meyer More articles by this author , Akshay SoodAkshay Sood More articles by this author , Firas AbdollahFiras Abdollah More articles by this author , Jesse SammonJesse Sammon More articles by this author , Malte VetterleinMalte Vetterlein More articles by this author , Björn LöppenbergBjörn Löppenberg More articles by this author , Julian HanskeJulian Hanske More articles by this author , Jeffrey LeowJeffrey Leow More articles by this author , Alexander ColeAlexander Cole More articles by this author , Adam KibelAdam Kibel More articles by this author , Maxine SunMaxine Sun More articles by this author , Mani MenonMani Menon More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1389AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In the current state of increasing medical expenditures, a critical appraisal of the benefits of minimally invasive surgery (MIS) in radical prostatectomy is needed, but lacking. Established benefits of MIS remain limited to reduced pain, lower blood loss, shorter hospital stay, better cosmesis and decreased surgical site infections. We sought to compare MIS vs. open RP 30-day postoperative outcomes including Clavien-Dindo graded complications, hospital stay, unplanned readmission and mortality. METHODS The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database provides a unique opportunity to evaluate 30-day outcomes following surgery. Relying on the ACS-NSQIP database (2005-2013), patients undergoing RP were identified. Non-parsimonious propensity score methods were used to construct procedure-specific matched-pair cohorts that reduced baseline differences between patients who underwent MIS RP as opposed to those that did not. Logistic regression models evaluated the association between surgical approaches for RP and outcomes. Bonferroni correction for multiple comparisons was applied and a p<0.006 was considered significant. Primary endpoints were Clavien-Dindo graded complications (I-V) and unplanned readmission within 30 days of surgery. RESULTS After propensity score matching, 5,401 patients underwent open or MIS RP, resulting in an overall sample of n=10,802. Within the procedure-specific matched-pairs, open RP was associated with significantly higher odds for Clavien-Dindo grade I-II, III and IV complications (OR=1.87, 95%CI=1.57-2.24; OR=1.93, 95%CI=1.33-2.81; OR=1.69, 95%CI=1.18-2.42 and OR=3.97, 95%CI=1.07-14.79, respectively), and unplanned readmissions (OR=1.08, 95% CI =0.98-1.18). CONCLUSIONS Open RP was associated with increased 30-day postoperative complications and unplanned readmissions. These findings have important implications on patient safety and health care costs. The utilization of MIS represents a modifiable factor of surgical outcomes, and its use should be strongly considered in suitable patients. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e901-e902 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Christian Meyer More articles by this author Akshay Sood More articles by this author Firas Abdollah More articles by this author Jesse Sammon More articles by this author Malte Vetterlein More articles by this author Björn Löppenberg More articles by this author Julian Hanske More articles by this author Jeffrey Leow More articles by this author Alexander Cole More articles by this author Adam Kibel More articles by this author Maxine Sun More articles by this author Mani Menon More articles by this author Quoc-Dien Trinh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...