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DOES PRIOR ABDOMINAL SURGERY INFLUENCE OUTCOMES OR COMPLICATIONS OF ROBOTIC-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY
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DOES PRIOR ABDOMINAL SURGERY INFLUENCE OUTCOMES OR COMPLICATIONS OF ROBOTIC-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY
Serge Ginzburg, MD1, Frances Hu2, Ilene Staff2, Joseph Tortora2, Alison Champagne2, Andrew Salner2, Steven J. Shichman, M.D.2, Stuart S. Kesler, M.D.2, Joseph R. Wagner, M.D.2, Vincent P. Laudone, M.D.2.
1University of Connecticut, West Hartford, CT, USA, 2Hartford Hospital, Hartford, CT, USA.
Background:
To determine if prior abdominal surgery is associated with longer operating time, increase in margin positivity or complications after robotic-assisted laparoscopic radical prostatectomy.
Methods: Retrospective data on presence and type of abdominal surgery prior to robotic-assisted laparoscopic prostatectomy was collected for all patients between January 1, 2004 and February 29, 2008. Patients with prior abdominal surgery were grouped into minor and major surgery categories. Major surgery was defined as laparoscopic or open bowel surgery, vascular surgery, bladder surgery or other. Minor surgery was defined as herniorrhaphy, cholecystectomy, appendectomy or other. Relevant demographic, intra-operative, pathologic and complications data were collected and analyzed retrospectively. Groups were compared with respect to total surgical time, robotic time, margin positivity and rate of complications.
Results:
1083 patients underwent robotic-assisted laparoscopic prostatectomy between January 1, 2004 and February 29, 2008 at our institution. 839 patients had sufficient data available for analysis. 18(2.1%) had major and 233(27.7%) had minor abdominal surgery. 588(70.1%) had no prior abdominal surgery. Total operating times were 220, 208 and 204 minutes for patients with major, minor and without prior abdominal surgery and were not statistically significant (p = 0.298). Robotic assistance times were 164, 165 and 163 minutes for patients with major, minor and without prior abdominal surgery, respectively, and were not statistically significant (p = 0.585). Margin positivity was noted to be 16.7%, 21.5% and 27.2% for patients with major, minor and without prior abdominal surgery and was not statistically significant (p = 0.160). The incidence of complications was 11.1%, 14.6% and 17.3% for patients with major, minor and without prior abdominal surgery, respectively, and was not statistically significant.
Conclusions:
Prior abdominal surgery was not associated with a statistically significant increase in robotic assisted time, margin positivity or the incidence of complications in patients undergoing robotic assisted laparoscopic prostatectomy. Overall surgical time was slightly longer for patients with prior abdominal surgery, but this was also not statistically significant.
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