Introduction The aim of this article was to analyze whether operative time and blood loss during radical prostatectomy (RP) can significantly influence surgical margins (SM) status and post-operative functional outcomes.Material and methods We prospectively analyzed prostate cancer (PC) patients undergoing RP, using robot-assisted (RARP) or laparoscopic (LRP) procedures. Blood loss was defined using the variation in hemoglobin (Hb, g/dl) values from the day before surgery and no later than 4 hours after surgery.Results From a whole population of 413 cases considered for RP, 67% underwent LRP and 33.0% RARP. Positive SM (SM+) were found in 33.9% of cases. Mean surgical operative time was 172.3 +/- 76 min (range 49-485), whereas blood loss was 2.3 +/- 1.2 g/dl (range 0.3-7.6). Operative time and blood loss at RP were not significantly correlated (r =-0.028275; p = 0.684). SM+ rates significantly (p = 0.002) varied by operative time; a higher SM+ rate was found in cases with an operative time <120 min (41.2%) and >240 min (53.4%). The risk of SM+ significantly increased 1.70 and 1.94 times in cases with an operative time <120 min and >240 min, respectively, independently to the surgical approach. The rate of erectile disfunction (ED) varied from 22.4% to 60.3% between <120 min and >240 min procedures (p = 0.001). According to blood loss, SM+ rates slightly but significantly (p = 0.032) varied; a higher rate of SM+ was found in cases with a Hb variation between 2-4 g/dl (35.9%).Conclusions Independently to the surgical approach, operative time, more than blood loss at RP, represents a significant variable able to influence SM status and post-operative ED.

Influence of operative time and blood loss on surgical margins and functional outcomes for laparoscopic versus robotic-assisted radical prostatectomy: a prospective analysis / Salciccia, Stefano; Rosati, Davide; Viscuso, Pietro; Canale, Vittorio; Scarrone, Emiliano; Frisenda, Marco; Catuzzi, Roberta; Moriconi, Martina; Asero, Vincenzo; Signore, Stefano; De Dominicis, Mauro; Emiliozzi, Paolo; Carbone, Antonio; Pastore, Antonio Luigi; Fuschi, Andrea; Di Pierro, Giovanni Battista; Gentilucci, Alessandro; Cattarino, Susanna; Mariotti, Gianna; Busetto, Gian Maria; Ferro, Matteo; De Berardinis, Ettore; Ricciuti, Gian Piero; Panebianco, Valeria; Magliocca, Fabio Massimo; Del Giudice, Francesco; Maggi, Martina; Sciarra, Alessandro. - In: CENTRAL EUROPEAN JOURNAL OF UROLOGY. - ISSN 2080-4806. - 74:4(2021), pp. 503-515. [10.5173/ceju.2021.0177]

Influence of operative time and blood loss on surgical margins and functional outcomes for laparoscopic versus robotic-assisted radical prostatectomy: a prospective analysis

Salciccia, Stefano
Primo
;
Viscuso, Pietro;Canale, Vittorio;Scarrone, Emiliano;Frisenda, Marco;Catuzzi, Roberta;Moriconi, Martina;Carbone, Antonio;Pastore, Antonio Luigi;Fuschi, Andrea;Di Pierro, Giovanni Battista;Gentilucci, Alessandro;De Berardinis, Ettore;Ricciuti, Gian Piero;Panebianco, Valeria;Magliocca, Fabio Massimo;Del Giudice, Francesco;Maggi, Martina
Penultimo
;
Sciarra, Alessandro
Ultimo
2021

Abstract

Introduction The aim of this article was to analyze whether operative time and blood loss during radical prostatectomy (RP) can significantly influence surgical margins (SM) status and post-operative functional outcomes.Material and methods We prospectively analyzed prostate cancer (PC) patients undergoing RP, using robot-assisted (RARP) or laparoscopic (LRP) procedures. Blood loss was defined using the variation in hemoglobin (Hb, g/dl) values from the day before surgery and no later than 4 hours after surgery.Results From a whole population of 413 cases considered for RP, 67% underwent LRP and 33.0% RARP. Positive SM (SM+) were found in 33.9% of cases. Mean surgical operative time was 172.3 +/- 76 min (range 49-485), whereas blood loss was 2.3 +/- 1.2 g/dl (range 0.3-7.6). Operative time and blood loss at RP were not significantly correlated (r =-0.028275; p = 0.684). SM+ rates significantly (p = 0.002) varied by operative time; a higher SM+ rate was found in cases with an operative time <120 min (41.2%) and >240 min (53.4%). The risk of SM+ significantly increased 1.70 and 1.94 times in cases with an operative time <120 min and >240 min, respectively, independently to the surgical approach. The rate of erectile disfunction (ED) varied from 22.4% to 60.3% between <120 min and >240 min procedures (p = 0.001). According to blood loss, SM+ rates slightly but significantly (p = 0.032) varied; a higher rate of SM+ was found in cases with a Hb variation between 2-4 g/dl (35.9%).Conclusions Independently to the surgical approach, operative time, more than blood loss at RP, represents a significant variable able to influence SM status and post-operative ED.
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Note: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8771133/
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1606676
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