National cohort study comparing severe medium-term urinary complications following radical prostatectomy: robot-assisted versus laparoscopic versus retropubic open radical prostatectomy.


Sujenthiran, A; Nossiter, J; Parry, M; Charman, SC; Aggarwal, A; Payne, H; Dasgupta, P; Clarke, NW; van der Meulen, J; Cathcart, P; (2017) National cohort study comparing severe medium-term urinary complications following radical prostatectomy: robot-assisted versus laparoscopic versus retropubic open radical prostatectomy. BJU international. ISSN 1464-4096 DOI: https://doi.org/10.1111/bju.14054

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Abstract

Despite the rapid adoption of robot-assisted radical prostatectomy (RARP), there is little evidence about the occurrence of medium-term urinary complications with this type of surgery compared to laparoscopic (LRP) or retropubic open radical prostatectomy (ORP). The aim of this study was to evaluate the occurrence of severe urinary complications within two years of surgery in men undergoing RARP, LRP or ORP. Population-based cohort study of men who underwent RARP (n=4,947), LRP (n= 5,479), or ORP (n=6,873) between 2008 and 2012 in the English National Health Service (NHS) using national cancer registry records linked to Hospital Episodes Statistics - an administrative database of admissions to NHS hospitals. We identified the occurrence of any severe urinary or severe stricture-related complication within two years of surgery using a validated tool. Multi-level regression modelling was used to determine the association between the type of surgery and occurrence of complications with adjustment for patient and surgical factors. Men undergoing RARP were least likely to experience any urinary complication (10.5%) or a stricture-related complication (3.3%) compared to those who had LRP (15.8% any or 5.7% stricture-related) or ORP (19.1% any or 6.9% stricture-related). The impact of the type of surgery on the occurrence of any urinary or stricture-related complications remained statistically significant with adjustment for patient and surgical factors (p < 0.01). Men who underwent RARP have the lowest risk of developing severe urinary complications within two years of surgery. This article is protected by copyright. All rights reserved.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
PubMed ID: 29032582
URI: http://researchonline.lshtm.ac.uk/id/eprint/4544430

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