Roboterassistierte radikale Prostatektomie

Kühne, K.-H.; Böhm, Karin; Schiffmann, Jonas; Heinzer, Hans; Michl, Uwe; Huland, Hartwig; Graefen, Markus; Haese, Alexander; Steuber, Thomas

doi:10.1007/s00120-014-3589-y

Cited by 9 publications

(3 citation statements)

References 25 publications

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“…Specifically, obese patients undergoing ORP were at higher risk to undergo a non-nerve sparing procedure, while this was not observed in RARP patients. This may be explained by the better visual conditions of RARP in obese patients, as already reported by Beyer et al (18). In multivariable adjusted analyses higher BMI failed (p = 0.06) to be an independent predictor of none or unilateral NVBP and only age could be investigated as an independent predictor.…”

Section: Discussionsupporting

confidence: 67%

The Effect of Adverse Patient Characteristics on Perioperative Outcomes in Open and Robot-Assisted Radical Prostatectomy

et al. 2020

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Section: Discussionsupporting

confidence: 67%

The Effect of Adverse Patient Characteristics on Perioperative Outcomes in Open and Robot-Assisted Radical Prostatectomy

et al. 2020

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“…Generally, prostatectomy in obese patients is linked with increased perioperative morbidity [ 10 ]. With the surge in robot-assisted radical prostatectomy (RARP), more obese patients are being considered for robot-assisted radical prostatectomy (RARP).…”

Section: Discussionmentioning

confidence: 99%

BMI Impact on Readmissions for Patients Undergoing Robot-Assisted Radical Prostatectomy: A Monocentric, Single-Surgeon Serial Analysis of 500 Cases

Farzat,

Sharabaty,

Tanislav

et al. 2023

JCM

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Due to more difficult intraoperative courses, elevated rates of case abortion and unfavored postoperative outcomes in obese patients, urologists tend to consider other therapeutic modalities than prostate removal in very obese patients. With the surge in robotic surgery in the last two decades, more obese patients have undergone robot-assisted radical prostatectomy (RARP). Objective: This current, monocentric, retrospective serial study investigates primarily the impact of obesity on readmissions and secondarily the major complications of RARP. Methods: Five hundred patients from one referral center who underwent RARP between April 2019 and August 2022 were included in this retrospective study. To investigate the impact of patient BMI on postoperative outcomes, we divided our cohort into two groups with a cut-off of 30 kg/m2 (according to the WHO definition). Demographic and perioperative data were analyzed. Postoperative complications and readmission rates were compared between standard, normal patients (NOBMI—BMI under 30; n = 336, 67.2%) and overweight patients (OBMI—BMI equal to/more than 30; n = 164, 32.8%). Results: OBMI patients had bigger prostates on TRUS, more comorbidities and worse baseline erectile function scores. They also received fewer nerve-sparing procedures than their counterparts (p = 0.005). Analysis showed no statistically significant differences in readmission rates or in minor or major complications (p = 0.336, 0.464 and 0.316, respectively). In a univariate analysis, BMI could predict positive surgical margins (p = 0.021). Conclusion: Performing RARP in obese patients seems to be safe and feasible, without major adverse events or elevated readmission rates. Obese patients should be informed preoperatively about the elevated risk of higher PSMs and technically more difficult nerve-sparing procedures.

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“…In patients undergoing prostatectomy, no study has ever been able to determine the real impact of obesity on QOL. Therefore, some studies recommend prostatectomy in obese patients given the advances in robot-assisted laparoscopic surgery [ 27 ]. Conversely, others consider obesity to be a predictor of adverse effects on QOL [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Association between overweight, obesity, and quality of life of patients receiving an anticancer treatment for prostate cancer: a systematic literature review

Depotte

Caroux

Gligorov

et al. 2023

Health Qual Life Outcomes

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Background Prostate cancer (PCa) and obesity are two ever-increasing public health issues that can independently impair the quality of life (QOL) of affected patients. Our objective was to evaluate the impact of overweight and obesity on the QOL of patients with PCa receiving an anticancer treatment. Methods We performed a systematic review of the literature using PubMed, Embase, Cochrane Library and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The search equation targeted studies that included PCa patients who had a body mass index (BMI) greater than 25 kg/m2, who were receiving anticancer therapy, and whose QOL was analyzed according to validated or non-validated scores. Results Of 759 identified articles, we selected 20 studies published between 2000 and 2019 of 12,529 patients treated for PCa, including 5549 overweight or obese patients. QOL assessment was performed using nine validated scales and two non-validated questionnaires. Of seven studies on radiotherapy, six found obesity to have a negative impact on patients' QOL (especially urinary, sexual, and bowel-related QOL). Thirteen studies assessed the QOL of patients who underwent radical prostatectomy, with a BMI > 25 kg/m2 having no observed impact. In obese patients under 65 years of age and without comorbidities, nerve-sparing surgery appeared to limit the deterioration of QOL. Four studies on brachytherapy found discordant results. One study showed greater QOL impairment in obese patients receiving first-generation hormone therapy than in those with normal or decreased BMI. No study evaluated the QOL of overweight or obese patients receiving other types of systemic treatment. Conclusion Based on the published data, the level of evidence for an association between QOL and overweight or obesity in patients treated for PCa is not high. Prospective cohort studies including this type of patient population are warranted to answer this topical public health issue.

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Roboterassistierte radikale Prostatektomie

Abstract: Our findings of decreased transfusion and complication rates and a trend of better early recovery of continence in RARP should be considered in obese patients (BMI >30) scheduled for radical prostatectomy.

Cited by 9 publications

References 25 publications

The Effect of Adverse Patient Characteristics on Perioperative Outcomes in Open and Robot-Assisted Radical Prostatectomy

The Effect of Adverse Patient Characteristics on Perioperative Outcomes in Open and Robot-Assisted Radical Prostatectomy

BMI Impact on Readmissions for Patients Undergoing Robot-Assisted Radical Prostatectomy: A Monocentric, Single-Surgeon Serial Analysis of 500 Cases

Association between overweight, obesity, and quality of life of patients receiving an anticancer treatment for prostate cancer: a systematic literature review

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