The role of body mass index on quality indicators following minimally-invasive radical prostatectomy

Pathak, R. S.; Wilson, Robert R.; Craven, Timothy E.; Matz, Ethan; Hemal, Ashok K.

doi:10.4111/icu.20200411

Cited by 5 publications

(5 citation statements)

References 24 publications

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“…Third, this study included non-obese patients. However, since obesity is known to be a risk factor for impaired respiratory mechanics [23,24] and complications [25], further study is needed to explore the effect of NMB on intraoperative respiratory mechanics in obese patients.…”

Section: Discussionmentioning

confidence: 99%

Effect of Neuromuscular Blockade on Intraoperative Respiratory Mechanics and Surgical Space Conditions during Robot-Assisted Radical Prostatectomy: A Prospective Randomized Controlled Trial

Koo

Park

Ahn

et al. 2021

JCM

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The aim of this study was to investigate whether deep neuromuscular blockade (NMB) may affect intraoperative respiratory mechanics, surgical condition, and recovery profiles in patients undergoing robot-assisted radical prostatectomy (RARP). Patients were randomly assigned to the moderate or deep NMB groups. Pneumoperitoneum was maintained with carbon dioxide (CO2) insufflation at 15 mmHg during surgery. The primary outcome was peak inspiratory pressure (PIP) after CO2 insufflation. Mean airway pressure (Pmean) and dynamic lung compliance (Cdyn) were also recorded. The surgeon rated the surgical condition and surgical difficulty on a five-point scale (1 = extremely poor; 2 = poor; 3 = acceptable; 4 = good; 5 = optimal). Recovery profiles, such as pulmonary complications, pain scores, and recovery time, were recorded. We included 58 patients in this study. No significant differences were observed regarding intraoperative respiratory mechanics including PIP, Pmean and Cdyn, between the two groups. The number of patients with optimal surgical conditions was significantly higher in the deep than in the moderate NMB group (29 vs. 20, p = 0.014). We found no differences in recovery profiles. In conclusion, deep NMB had no significant effect on the intraoperative respiratory mechanics but resulted in optimal endoscopic surgical conditions during RARP compared with moderate NMB.

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Section: Discussionmentioning

confidence: 99%

Effect of Neuromuscular Blockade on Intraoperative Respiratory Mechanics and Surgical Space Conditions during Robot-Assisted Radical Prostatectomy: A Prospective Randomized Controlled Trial

Koo

Park

Ahn

et al. 2021

JCM

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“…A 2021 double-blind, placebo-controlled study by Pathak et al 32 investigated the effects of obesity on quality indicators such as length of stay and readmission after minimally invasive-radical retropubic prostatectomy (MI-RRP). The study found that obese patients experienced prolonged length of stay, increased readmission rates, and higher overall morbidity than non-obese patients, and there was a negative correlation between obesity severity and quality indicators.…”

Section: Risks Of Robotic Pelvic Surgery In Obese Patientsmentioning

confidence: 99%

“…Overall, these data suggest that in patients undergoing MI-RRP, obesity increases the risk of poor quality outcomes; therefore, physicians should carefully consider these risks and discuss them with their at-risk patients. 32 …”

Section: Risks Of Robotic Pelvic Surgery In Obese Patientsmentioning

confidence: 99%

Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients

Khater,

Morris,

Vanvalkenburg

et al. 2024

TJAR

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Obesity is associated with many significant physiological changes. These considerations are important to surgery, especially in urological procedures. Obese patients often undergo surgical procedures and are at higher risk of complications. This investigation reviews physiological and anaesthesia considerations for obese and morbidly obese patients. In addition, urological surgeries and procedures should be considered for these higher risk patients. Clinical anaesthesiologists must use detailed assessment and, when appropriate, consultation in developing safe anaesthesia plans for these patients. Newer technologies have improved safety related to airway management, advanced airway devices, and regional anaesthesia with ultrasound-guided nerve blocks, which can reduce the need for opioids postoperatively. Recent developments in drug and monitoring technologies have also been developed and can be effective for obese and morbidly obese patients undergoing urological procedures and perioperative surgery, thus improving the likelihood of safety in this higher risk population.

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“…However, despite such observations and the well-established epidemiological link between obesity and the severity of prostate cancer ( 11 , 12 ), some reports raise questions about t the actual role of obesity in the progression of prostate cancer. For example, Lo and colleagues (2016) reported that obesity failed to promote tumorigenesis in localized patient-derived prostate cancer xenografts in severe combined immunodeficiency (SCID) mice ( 13 ).…”

Section: Igf-1r Signaling: a Key Link Between Metabolic Syndrome And ...mentioning

confidence: 99%

“…Insulin-like growth factors (IGFs) are abundantly released by both malignant cells and the tumor microenvironment during tumorigenesis, metastasis, and the development of anticancer drug resistance (11)(12)(13). Silencing IGF-1R signaling has emerged as a promising strategy against cancer and for overcoming cancer drug resistance, as illustrated by a recent report of the antioxidant molecule vitamin D regulating apoptosis and autophagy and supporting the DNA repair process of cancer cells partly by silencing IGF-1R signaling and its downstream target, b-catenin (14).…”

Section: Introductionmentioning

confidence: 99%

Insulin-like growth factor-1 signaling in the tumor microenvironment: Carcinogenesis, cancer drug resistance, and therapeutic potential

Kamdje¹,

Etet

Kipanyula

et al. 2022

Front. Endocrinol.

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The tumor microenvironment fuels tumorigenesis and induces the development of resistance to anticancer drugs. A growing number of reports support that the tumor microenvironment mediates these deleterious effects partly by overexpressing insulin-like growth factor 1 (IGF-1). IGF-1 is known for its role to support cancer progression and metastasis through the promotion of neovascularization in transforming tissues, and the promotion of the proliferation, maintenance and migration of malignant cells. Anti-IGF therapies showed potent anticancer effects and the ability to suppress cancer resistance to various chemotherapy drugs in in vivo and in vitro preclinical studies. However, high toxicity and resistance to these agents are increasingly being reported in clinical trials. We review data supporting the notion that tumor microenvironment mediates tumorigenesis partly through IGF-1 signaling pathway. We also discuss the therapeutic potential of IGF-1 receptor targeting, with special emphasis on the ability of IGF-R silencing to overcome chemotherapy drug resistance, as well as the challenges for clinical use of anti-IGF-1R therapies.

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The role of body mass index on quality indicators following minimally-invasive radical prostatectomy

Cited by 5 publications

References 24 publications

Effect of Neuromuscular Blockade on Intraoperative Respiratory Mechanics and Surgical Space Conditions during Robot-Assisted Radical Prostatectomy: A Prospective Randomized Controlled Trial

Effect of Neuromuscular Blockade on Intraoperative Respiratory Mechanics and Surgical Space Conditions during Robot-Assisted Radical Prostatectomy: A Prospective Randomized Controlled Trial

Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients

Insulin-like growth factor-1 signaling in the tumor microenvironment: Carcinogenesis, cancer drug resistance, and therapeutic potential

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