Impact of body mass index on outcomes of laparoscopic radical prostatectomy with long-term follow-up

Gözen, Ali Serdar; Akın, Yiğit; Özden, Ender; Ateş, Mutlu; Hruza, Marcel; Rassweiler, Jens

doi:10.3109/21681805.2014.920416

Cited by 11 publications

(21 citation statements)

References 38 publications

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“…Amling et al (18) stated that obese patients developed prostate cancer at younger ages and in advanced stages, however, another series showed that the average ages and PSA levels were not statistically different (4,5). In our study, there was no statistically significant difference in PSA levels between normal and obese patients.…”

Section: Discussioncontrasting

confidence: 62%

“…Chronic inflammation, hypoxia induced by obesity, and defects in the immune functions are the presumed reasons for this situation (22). Especially, pT3 disease and Gleason scores over 7 were statistically high (5,6,23,24). Lower PSA levels due to the greater body areas in obese patients and late diagnoses have been suggested to be reasons for a more aggressive and advanced stage disease (21).…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies are available regarding the effects of obesity on robot-assisted laparoscopic prostatectomy (RALP) and laparoscopic radical prostatectomy (LRP) surgeries. In some case series, the operation time, blood loss, and disease stage in obese patient groups were reported to increase (4,5). However, in other studies, no effects on the intraoperative and early oncological periods were seen (6).…”

Section: Introductionmentioning

confidence: 95%

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Effects of Obesity on the Perioperative Results and Continence Status in Laparoscopic Radical Prostatectomy

Kaygısız¹,

Özmerdiven²,

Vuruşkan³

et al. 2017

jus

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Objective: To assess the effects of obesity on the surgical success and perioperative results and continence status in laparoscopic radical prostatectomy (LRP). Materials and Methods:The results of 300 consecutive patients undergoing LRP between April 2004 and January 2014 were analyzed retrospectively. Twenty patients were excluded from the study, thus, 280 patients remained. The patients were separated into 3 groups according to their body mass index. Based on this classification, group 1 (<25 kg/m 2 ) was normal, group 2 (25-30 kg/m 2 ) was overweight, and group 3 (>30 kg/m 2 ) was obese. The demographic data, intraoperative results, pathological results, and states of continence were compared among the groups. Results: There were 81 patients in group 1, 152 patients in group 2, and 47 patients in group 3. There were no significant differences when the groups were compared according to age and prostate specific antigen values. The intraoperative blood loss was high in group 3 only. Moreover, the estimated blood loss, transfusion, operative time, bilateral nerve-sparing rate, hospitalization days, and complication rate were similar between the groups. There were no significant differences when the pathological results were compared according to the positive surgical margins and Gleason scores. Although the continence rates in group 3 were significantly low 6 months after the operation (p<0.05), the results were similar at 1 year (p=0.738). Conclusion: LRP can be applied confidently in obese patients as well as normal and overweight patients. Keywords: Body mass index, laparoscopic surgery, obesity, prostatectomy In this study, we reviewed the outcomes of initial 300 surgeries. The results showed the obese patients can operated even at the early stages of the learning. The urinary continence rate in obese patients were lower than the others at 6 th month. However, these rates were similar at one year follow-up. There is more information regarding obesity and robot assisted prostatectomy according to laparoscopic radical prostatectomy. The series regarding laparoscopic radical prostatectomy and obesity have large number of patients or long ago studied. Therefore, the current study will provide additional information to the literature and will guide to the surgeons who are willing to perform laparoscopic radical prostatectomy.

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Section: Discussioncontrasting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

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Effects of Obesity on the Perioperative Results and Continence Status in Laparoscopic Radical Prostatectomy

Kaygısız¹,

Özmerdiven²,

Vuruşkan³

et al. 2017

jus

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“…[34][35] In contrast, obesity has been linked to increased operative times in both laparoscopic and robotic radical prostatectomy. [36][37] The thick anterior abdominal wall and peritoneal layer complicates insufflation and the placement of trocars. Depending on the degree of adiposity, when placed in the lateral decubitus position, the pannus and umbilicus may fall away from the side of interest.…”

Section: Morbid Obesitymentioning

confidence: 99%

Trocars: Site Selection, Instrumentation, and Overcoming Complications

Gaunay

Elsamra

Richstone

2016

Journal of Endourology

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In recent years, laparoscopy and robot-assisted procedures have become more commonplace in urology. Incorporation of these techniques into clinical practice requires extensive knowledge of the surgical approaches and complex instrumentation unique to minimally invasive surgery. In this review, focus will be directed to laparoscopic trocars including differing subtypes, placement in select urologic procedures, and proper use with emphasis on the avoidance of complications. Differing methods for the development of pneumoperitoneum and the associated risks of each will be discussed. The aim of this article is to provide a complete review of laparoscopic trocar use for the practicing urologist.

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“…Laparoscopic radical prostatectomy (LRP) is the first-line treatment option offered to men to treat localised prostate cancer [1,2]. The critical step of the procedure is formation of a watertight vesicourethral anastomosis (VUA).…”

Section: Introductionmentioning

confidence: 99%

Single Running Suture versus Single-Knot Running Suture for Vesicourethral Anastomosis in Laparoscopic Radical Prostatectomy: A Prospective Randomised Comparative Study

et al. 2015

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Aim: To investigate the safety, surgical efficiency and patients' ability to recover from urinary continence as a result of a single absorbable running suture versus single-knot running suture for vesicourethral anastomosis (VUA) during laparoscopic radical prostatectomy (LRP). Material and Methods: In a prospective randomised study, we evaluated 162 consecutive patients who underwent LRP with VUA using the single running suture technique or the single-knot running suture technique. Perioperative patients' characteristics, morbidity and urinary continence were analysed. Results: The baseline characteristics were similar between the 2 groups. The single running suture technique was related to decreased anastomotic and total operative times compared with the Van Velthoven technique (13.17 ± 5.74 min vs. 28.49 ± 6.45 min, p = 0.0001, and 174.41 ± 62.97 min and 184.94 ± 46.16 min, p = 0.04, respectively). Overall, urinary continence rates at 3, 6 and 12 months in groups 1 and 2 were 49.4 and 69.1%, 81.5 and 86.4%, and 91.4 and 93.8%, respectively (all with p > 0.05 except the follow-up assessment at 3 months following surgery, p = 0.011). Conclusions: Both methods ensure satisfactory rates of urinary leakage and bladder neck stricture, as well as continence after LRP. However, since the single running suture VUA technique is easier to perform, and the mean anastomosis time of the single running suture VUA technique is shorter than that of the Van Velthoven technique, it appears, therefore, preferable.

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Impact of body mass index on outcomes of laparoscopic radical prostatectomy with long-term follow-up

Abstract: LRP seemed safe and effective in obese patients, with similar mean overall survival, cancer-specific survival, complication rates and continence rates to normal weight patients in the long term.

Cited by 11 publications

References 38 publications

Effects of Obesity on the Perioperative Results and Continence Status in Laparoscopic Radical Prostatectomy

Effects of Obesity on the Perioperative Results and Continence Status in Laparoscopic Radical Prostatectomy

Trocars: Site Selection, Instrumentation, and Overcoming Complications

Single Running Suture versus Single-Knot Running Suture for Vesicourethral Anastomosis in Laparoscopic Radical Prostatectomy: A Prospective Randomised Comparative Study

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