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Does obesity influence operative course or complications of robot assisted laparoscopic prostatectomy

摘要

Introduction and Objective: To determine if obesity is associated with greater intra or peri‐operative complications in patients undergoing Robot Assisted Laparoscopic Prostatectomy (RALP). Methods: Between 8/2003 and 9/2005 prospective data collection was performed for all patients undergoing RALP. Obesity was defined by BMI > 30 Kg/m 2 . Operative times were documented to determine duration for: overall case, robotic assistance, vesico‐urethral anastomosis. Results: Two hundred and forty three patients underwent RALP by one of two surgeons. 202 were classified as non‐obese and 41 obese. Preoperative and postoperative characteristics were similar: mean age 61.1 vs. 59.8 years, preoperative PSA 8.1 vs. 7.4, prostate volume was 46.6 vs. 45.3 cc, length of stay 3.2 vs. 3.4 days, time of indwelling catheter 8.2 vs.7.8 days. Operative times were less for the non‐obese group compared with the obese group: total OR Time 188 vs. 206 min ( P < 0.05), Robot Time 135 vs. 147 min ( P < 0.10), Anastomotic Time 31 vs. 35 min ( P < 0.10). In the non‐obese group there were seven (3.5%) prolonged drain tube leaks versus four (9.8%) in the obese group ( P < 0.10). Conclusions: Obesity was associated with longer overall operative times, which reinforces the suspicion that RARP is more challenging in this population. Overall complication rates were not significantly different; however there was a trend towards longer drain tube output amongst obese patients. Ongoing follow‐up will determine if obesity predisposed to greater long‐term morbidity.