Key result
Preoperative cardiovascular and pulmonary diseases linked to up to ~229% greater major postoperative complication risk.
Why the study?
Certain comorbidities may be associated with a higher risk of short-term major postoperative complications after robotic-assisted radical prostatectomy.
Does the presence of cardiovascular disease or chronic pulmonary disease increase the risk of short-term major postoperative complications in patients undergoing robotic-assisted radical prostatectomy?
Cohort (n=1,148)
No
Does the presence of cardiovascular disease or chronic pulmonary disease increase the risk of short-term major postoperative complications in patients undergoing robotic-assisted radical prostatectomy?
Concomitant cardiovascular disease and chronic pulmonary disease are significant independent risk factors for short-term major postoperative complications following robotic-assisted radical prostatectomy.
Alerts clinicians to heightened complication risks with cardiopulmonary disease in robotic prostatectomy; leaves open whether optimization alters outcomes in prospective studies.
Background and objectives: Certain comorbidities may be associated with a higher risk of complications after robotic-assisted radical prostatectomy. Material and Methods: Relying on a tertiary care database, we identified robotic-assisted radical prostatectomy patients (January 2014–March 2023). Short-term major postoperative complications were defined according to Clavien Dindo as ≥IIIa within 30 days after robotic-assisted radical prostatectomy. Results: Of 1148 patients, the rates of postoperative Clavien Dindo IIIa, Clavien Dindo IIIb, Clavien Dindo IVa, and Clavien Dindo IVb complications were 3.3%, 1.4%, 0.3%, and 0.2%, respectively. Of those, 28 (47%) had lymphoceles, and 8 (13%) had bleeding-associated complications. Patients with cardiovascular disease (8 vs. 4%) or chronic pulmonary disease (13 vs. 5%) were more likely to have complications. In multivariable logistic regression models, cardiovascular disease (odds ratio: 1.78; p = 0.046) and chronic pulmonary disease (odds ratio: 3.29; p = 0.007) remained associated with an increased risk of postoperative complications. Conclusions: Complications after robotic-assisted radical prostatectomy are predominantly manageable without anesthesia. Concomitant cardiovascular disease and chronic pulmonary disease were both associated with a higher risk of postoperative complications.
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Siech et al. (2024) conducted a cohort in Prostate cancer (n=1,148). Chronic pulmonary disease vs. Patients without chronic pulmonary disease was evaluated on Short-term major postoperative complications (Clavien Dindo ≥ IIIa within 30 days) (OR 3.29, 95% CI 1.28-7.44, p=0.007). Preoperative chronic pulmonary disease and cardiovascular disease independently increased the risk of short-term major postoperative complications after robotic-assisted radical prostatectomy (OR 3.29 and 1.78, respectively).
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