465 SAFETY PROFILE OF ROBOT-ASSISTED RADICAL PROSTATECTOMY: A STANDARDIZED REPORT OF COMPLICATIONS IN 3317 PATIENTS

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You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History1 Apr 2011465 SAFETY PROFILE OF ROBOT-ASSISTED RADICAL PROSTATECTOMY: A STANDARDIZED REPORT OF COMPLICATIONS IN 3317 PATIENTS Piyush K. Agarwal, Jesse Sammon, Akshay Bhadari, Ali Dabaja, Mireya Diaz, Stacey Dusik-Fenton, Ramgopal Satyanarayna, Andrea Simone, Quoc-Dien Trinh, Brad Baize, and Mani Menon Piyush K. AgarwalPiyush K. Agarwal Detroit, MI More articles by this author , Jesse SammonJesse Sammon Detroit, MI More articles by this author , Akshay BhadariAkshay Bhadari Detroit, MI More articles by this author , Ali DabajaAli Dabaja Detroit, MI More articles by this author , Mireya DiazMireya Diaz Detroit, MI More articles by this author , Stacey Dusik-FentonStacey Dusik-Fenton Detroit, MI More articles by this author , Ramgopal SatyanaraynaRamgopal Satyanarayna Detroit, MI More articles by this author , Andrea SimoneAndrea Simone Detroit, MI More articles by this author , Quoc-Dien TrinhQuoc-Dien Trinh Detroit, MI More articles by this author , Brad BaizeBrad Baize Detroit, MI More articles by this author , and Mani MenonMani Menon Detroit, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.558AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Previous studies attempting to study complications after robot-assisted radical prostatectomy (RARP) are limited by small numbers, short follow-up, or lack of risk-factor analysis. Our objective was to document complications after RARP by strict application of standardized reporting criteria. METHODS Between January 2005 and December 2009, 3317 consecutive patients underwent RARP at a tertiary referral center. Median follow-up was 24.2 months. Complications were captured by exhaustive review of multiple datasets including our prospective prostate cancer database, claims data, electronic medical records, and institutional morbidity and mortality records. These were then reported according to the Martin-Donat criteria. Complications were stratified by type (medical / surgical), Clavien classification, and timing of onset. Multivariable analysis of factors predictive of complications was performed. RESULTS The median hospitalization was 1 d. There were 349 complications in 302 patients (9.1%), including a transfusion rate of 2.2%. We detected 81 medical complications in 80 patients (2.4%) and 268 surgical complications in 222 patients (6.7%). There were 223 minor (Clavien III) and 126 major (Clavien III–V) complications. 278 (79.7%) complications occurred within 30 d, 18 (5.2%) within 31–90 d, and 53 (15.2%) after 90 d from surgery. On multivariable analysis, only cardiac co-morbidity was predictive for medical complications whereas cardiac, hepatic, and gastrointestinal diseases and positive lymph node status were predictive for surgical complications. Limitations of this study are that it represents results from a single high volume referral center and does not include the learning curve of the two most experienced surgeons. CONCLUSIONS RARP was a safe operation with an overall complication rate of 9.1%. Most complications occurred within 30 days of surgery. On risk factor analysis, cardiac co-morbidity was predictive for both medical and surgical complications. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e189 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Piyush K. Agarwal Detroit, MI More articles by this author Jesse Sammon Detroit, MI More articles by this author Akshay Bhadari Detroit, MI More articles by this author Ali Dabaja Detroit, MI More articles by this author Mireya Diaz Detroit, MI More articles by this author Stacey Dusik-Fenton Detroit, MI More articles by this author Ramgo