A Comprehensive Overview of Intraoperative Complications during Retzius-Sparing Robot-Assisted Radical Prostatectomy: Single Series from High-Volume Center
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Variables of Interest and Study Endpoints
2.3. Surgical Technique
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Description of the Complication and EAUiaiC Grade | n, (%) | During RARP/ePNLD | |
---|---|---|---|
Anesthesiologic ICs, n = 2 (5%) | Desaturation during pneumoperitoneum induction requiring open conversion Grade 2 | 1 (2.5) | |
Hemodynamic instability during ePLND, only one side performed Grade 4b | 1 (2.5) | ||
Access and trocar placement ICs, n = 5 (12.5%) | Epigastric artery Injury Grade 1 | 5 (12.5) | RARP |
Injury of intra-abdominal organs, n = 15 (37.5%) | Bladder injuries managed with immediate repair Grade 1 | 5 (12.5) | RARP |
Sigma injuries managed with immediate repair Grade 1 | 4 (10) | RARP | |
Small bowel injuries requiring suture Grade 1 | 5 (12.5) | RARP | |
Severe small bowel injury requiring resection and anastomosis Grade 2 | 1 (2.5) | RARP | |
Vascular injuries, n = 9 (22.5%) | Minor internal iliac artery injuries Grade 1 | 3 (7.5) | ePNLD |
Major internal iliac artery injury Grade 3 | 2 (5) | ePNLD | |
Gluteal vein injuries Grade 1 | 2 (5) | ePNLD | |
Iliac vein injuries Grade 1 | 2 (5) | ePNLD | |
Nerve, n = 3 (7.5%) | Obturatory nerve injury Grade 2 | 3 (7.5) | ePNLD |
Ureteric injuries, n = 4 (10%) | Ureteral injury with suture and stenting Grade 2 | 2 (5) | ePNLD |
Ureteral injury with anastomosis/reimplantation Grade 4a | 2 (5) | 1 RARP 1ePNLD | |
Others, n = 2 (5%) | Needle loss Grade 1 | 1 (2.5) | RARP |
Robot malfunctioning Grade 4b | 1 (2.5) | ePNLD |
ICs (n = 40) | No ICs (n = 1851) | p Value | |
---|---|---|---|
Age, years, median (IQR) | 67 (62.9–73.3) | 65 (59.9–69.2) | 0.029 |
BMI, kg/mq, median (IQR) | 27.0 (24.7–28.8) | 26.1 (24.2–28.4) | 0.018 |
Charlson comorbidity index, n (%) | 0.9 | ||
0 | 27 (67.5) | 1349 (72.9) | |
1 | 5 (12.5) | 235 (12.7) | |
2 | 5 (12.5) | 174 (9.4) | |
3 | 3 (7.5) | 93 (5.0) | |
Previous abdominal surgery, n (%) | 16 (240) | 629 (34) | 0.4 |
Previous surgery for BPH, n (%) | 3 (7.5) | 91 (4.9) | 0.5 |
PSA at RS-RARP, ng/mL, median (IQR) | 6.88 (4.7–11) | 7.0 (5.1–9.9) | 0.7 |
ISUP grade group at prostate biopsy, n (%) | 0.1 | ||
1 | 15 (37.5) | 859 (46.4) | |
2 | 8 (20) | 478 (25.8) | |
3 | 4 (10) | 194 (10.5) | |
4 | 11 (27.5) | 244 (13.2) | |
5 | 2 (5) | 76 (4.1) | |
EAU risk classification group, n (%) | 0.3 | ||
Low | 12 (30) | 614 (33.2) | |
Intermediate | 14 (35) | 785 (42.4) | |
High | 14 (35) | 452 (24.4) | |
Estimated blood loss, ml, median (IQR) | 250 (100–350) | 200 (100–250) | 0.2 |
Intraoperative blood transfusion, n (%) | 3 (13.3) | 17 (0.9) | <0.01 |
Length of stay > 3 days, n (%) | 8 (20) | 149 (8) | 0.015 |
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Olivero, A.; Tappero, S.; Chierigo, F.; Maltzman, O.; Secco, S.; Palagonia, E.; Piccione, A.; Bocciardi, A.M.; Galfano, A.; Dell’Oglio, P. A Comprehensive Overview of Intraoperative Complications during Retzius-Sparing Robot-Assisted Radical Prostatectomy: Single Series from High-Volume Center. Cancers 2024, 16, 1385. https://doi.org/10.3390/cancers16071385
Olivero A, Tappero S, Chierigo F, Maltzman O, Secco S, Palagonia E, Piccione A, Bocciardi AM, Galfano A, Dell’Oglio P. A Comprehensive Overview of Intraoperative Complications during Retzius-Sparing Robot-Assisted Radical Prostatectomy: Single Series from High-Volume Center. Cancers. 2024; 16(7):1385. https://doi.org/10.3390/cancers16071385
Chicago/Turabian StyleOlivero, Alberto, Stefano Tappero, Francesco Chierigo, Ofir Maltzman, Silvia Secco, Erika Palagonia, Antonio Piccione, Aldo Massimo Bocciardi, Antonio Galfano, and Paolo Dell’Oglio. 2024. "A Comprehensive Overview of Intraoperative Complications during Retzius-Sparing Robot-Assisted Radical Prostatectomy: Single Series from High-Volume Center" Cancers 16, no. 7: 1385. https://doi.org/10.3390/cancers16071385
APA StyleOlivero, A., Tappero, S., Chierigo, F., Maltzman, O., Secco, S., Palagonia, E., Piccione, A., Bocciardi, A. M., Galfano, A., & Dell’Oglio, P. (2024). A Comprehensive Overview of Intraoperative Complications during Retzius-Sparing Robot-Assisted Radical Prostatectomy: Single Series from High-Volume Center. Cancers, 16(7), 1385. https://doi.org/10.3390/cancers16071385