Dataset Information

Risk of hernia formation after radical prostatectomy: a comparison between open and robot-assisted laparoscopic radical prostatectomy within the prospectively controlled LAPPRO trial.

ABSTRACT:

Purpose

In addition to incisional hernia, inguinal hernia is a recognized complication to radical retropubic prostatectomy. To compare the risk of developing inguinal and incisional hernias after open radical prostatectomy compared to robot-assisted laparoscopic prostatectomy.

Method

Patients planned for prostatectomy were enrolled in the prospective, controlled LAPPRO trial between September 2008 and November 2011 at 14 hospitals in Sweden. Information regarding patient characteristics, operative techniques and occurrence of postoperative inguinal and incisional hernia were retrieved using six clinical record forms and four validated questionnaires.

Results

3447 patients operated with radical prostatectomy were analyzed. Within 24 months, 262 patients developed an inguinal hernia, 189 (7.3%) after robot-assisted laparoscopic prostatectomy and 73 (8.4%) after open radical prostatectomy. The relative risk of having an inguinal hernia after robot-assisted laparoscopic prostatectomy was 18% lower compared to open radical retropubic prostatectomy, a non-significant difference. Risk factors for developing an inguinal hernia after prostatectomy were increased age, low BMI and previous hernia repair. The incidence of incisional hernia was low regardless of surgical technique. Limitations are the non-randomised setting.

Conclusions

We found no difference in incidence of inguinal hernia after open retropubic and robot-assisted laparoscopic radical prostatectomy. The low incidence of incisional hernia after both procedures did not allow for statistical analysis. Risk factors for developing an inguinal hernia after prostatectomy were increased age and BMI.

SUBMITTER: Nilsson H

PROVIDER: S-EPMC8881255 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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Publications

Risk of hernia formation after radical prostatectomy: a comparison between open and robot-assisted laparoscopic radical prostatectomy within the prospectively controlled LAPPRO trial.

Nilsson H H Stranne J J Hugosson J J Wessman C C Steineck G G Bjartell A A Carlsson S S Thorsteinsdottir T T Tyritzis S I SI Lantz A A Wiklund P P Haglind E E

Hernia : the journal of hernias and abdominal wall surgery 20200411 1

<h4>Purpose</h4>In addition to incisional hernia, inguinal hernia is a recognized complication to radical retropubic prostatectomy. To compare the risk of developing inguinal and incisional hernias after open radical prostatectomy compared to robot-assisted laparoscopic prostatectomy.<h4>Method</h4>Patients planned for prostatectomy were enrolled in the prospective, controlled LAPPRO trial between September 2008 and November 2011 at 14 hospitals in Sweden. Information regarding patient character ...[more]

PMID: 32279170

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Project description:ContextThe advantages of minimally invasive surgery for radical prostatectomy (RP) have been demonstrated in a number of systematic reviews (SRs). However, the rigorous study selection process for SR means that a lot of information can be excluded, leading to a very specific clinical scenario that is often unrepresentative of real life. Our new reverse SR methodology generates a heterogeneous population database that covers a wide range of clinical scenarios.ObjectiveTo compare perioperative surgical results and complications for open retropubic RP (RRP), laparoscopic RP (LRP), and robot-assisted RP (RARP) in a reverse SR.Evidence acquisitionEight databases were searched for SRs on RRP, LRP, or RARP between 2000 and 2020 (80 SRs). All references used in these SRs were captured for analysis (1724 articles). Perioperative outcomes and complications were compared among the RRP, LRP, and RARP approaches.Evidence synthesisWe identified 559 (32.4%) reports on RRP, 413 (23.9%) on LRP, and 752 (43.7%) on RARP, involving 1 353 485 patients overall. RARP showed a significantly higher annual volume of surgery per surgeon (AVSS) in comparison to RRP and LRP (mean 64.29, 43.26, and 41.47, respectively), a higher percentage of low-risk patients (prostate-specific antigen <10 ng/ml, Gleason <7, stage <cT2), and a lower rate of lymphadenectomy, culminating in a lower complication rate (12.3% for RARP, 16.3% for LRP, 20.2% for RRP). Among all outcomes, only AVSS was significantly correlated with complication rates. An AVSS of 30, 95 and 95 surgeries/yr was required for RARP, LRP, and RRP, respectively, to obtain a complication rate of 12.3% (average for RARP). RARP showed better performance for all perioperative variables studied except for operative time (operative time: 199.8 vs 214.9 vs 169.5 min; estimated blood loss: 228.2 vs 408.0 vs 852.1 ml; blood transfusion rate: 2.8% vs 6.5% vs 19.8%; length of stay: 2.9 vs 5.7 vs 6.1 d; catheter time: 7.8 vs 8.5 vs 11.0 d for RARP vs LRP vs RRP).ConclusionsOur reverse SR involved a wide real-life representative sample and reference values established in the literature and revealed that minimally invasive surgery had the best perioperative and complication results, especially RARP, which was associated with less complex cases, higher annual surgeon volume, and greater performance.Patient summaryWe used a wide sample representative of real-life surgical practice and reference values established in the literature for three techniques for removal of the prostate to guide patients and physicians in deciding the best surgical treatment for prostate cancer according to availability.

Dataset Information

Risk of hernia formation after radical prostatectomy: a comparison between open and robot-assisted laparoscopic radical prostatectomy within the prospectively controlled LAPPRO trial.

Purpose

Method

Results

Conclusions

Publications

Risk of hernia formation after radical prostatectomy: a comparison between open and robot-assisted laparoscopic radical prostatectomy within the prospectively controlled LAPPRO trial.

Similar Datasets

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