Impact of prior abdominal surgery on the outcomes after robotic - assisted laparoscopic radical prostatectomy: single center experience

Abstract

Purpose:To evaluate the influence of prior abdominal surgery on the outcomes after robotic-assisted laparoscopic radical prostatectomy (RALP).Materials and Methods:We retrospectively analyzed patients with prostate cancer who underwent RALP between June 2012 and February 2015 at our institution. Patients with prior abdominal surgery were compared with those without prior surgery while considering the mean total operating, console, and port-insertion times; mean estimated blood loss; positive surgical margin rate; mean duration of catheterization; and rate of complications.Results:A total of 203 patients who underwent RALP during the study period were included in this study. In all, 65 patients (32%) had a prior history of abdominal surgery, whereas 138 patients (68%) had no prior history. The total operating, console, and port-insertion times were 328 and 308 (P=0.06), 252 and 242 (P=0.28), and 22 and 17 minutes (P=0.01), respectively, for patients with prior and no prior surgery. The estimated blood losses, positive surgical margin rates, mean durations of catheterization, and complication rates were 197 and 170 mL (P=0.29), 26.2% and 20.2% (P=0.32), 7.1 and 6.8 days (P=0.74), and 12.3% and 8.7% (P=0.42), respectively. Furthermore, whether prior abdominal surgery was performed above or below the umbilicus or whether single or multiple surgeries were performed did not further affect the perioperative outcomes.Conclusions:Our results suggest that RALP can be performed safely in patients with prior abdominal surgery, without increasing the risk of complications.

Efficacy and safety of single port robotic radical prostatectomy and multiport robotic radical prostatectomy: a systematic review and meta-analysis

“…The risk of bias in patient selection in 8 clinical trials (29)(30)(31)(32)(33)(34)(35)(36) was assessed using the Cochrane bias risk assessment tool.…”

“…In the further screening, 68 articles were excluded due to insufficient data, article types, and failure of research design. Finally, 8 papers were included in the analysis (29)(30)(31)(32)(33)(34)(35)(36). Figure 1 is a flowchart that reflects the identification, inclusion, and elimination of publications in the search process.…”

Radical prostatectomy outcomes in renal transplant recipients: a retrospective case series of Thai patients

“…In our experience, we do not believe that RP should be avoided in selected patients even with the history of abdominal surgery. Some previous literature revealed that prior abdominal surgery does not impact surgical outcomes and complications [ 17 ]. Even, there are potentially risks of injury due to smaller working space, adhesion, and transplanted renal and ureter, the surgery itself is possible.…”

Systematic Review and Meta-Analysis Assessing Perioperative and Oncologic Outcomes in Patients Undergoing Urologic Procedures with a History of Prior Abdominal/Pelvic Surgery: Study Protocol

“…Previous studies have assessed the impact of prior abdominal intervention on subsequent urologic surgeries [10][11][12]. For example, one study assessing outcomes following partial nephrectomy showed that PAS was associated with higher estimated blood loss [4].…”