FREE DAILY AND WEEKLY NEWSLETTERS OFFERED BY CONTENT OF INTEREST
Did you find this article relevant? Subscribe to UroToday-GUOncToday!
The fields of GU Oncology and Urology are advancing rapidly including new treatments, enrolling clinical trials, screening and surveillance recommendations along with updated guidelines. Join us as one of our subscribers who rely on UroToday as their must-read source for the latest news and data on drugs. Sign up today for blogs, video conversations, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.
Antegrade LRP has been shown to harbor less complications compared to the posterior approach. The anterior approach has significantly lower rates of blood loss, and less need for transfusions, lower mean anastomosis time, and reduced mean hospitalization time.
CO2 embolus can occur due to misplacement of the Veress needle, lesion of a large vein together with pneumoperitoneum. It is manifested with hypotension, hypoxemia, millwheel murmur, arrhythmia, pulmonary edema, and right ventricular distension. Subclinical gas embolisms occur in 17.1% of LRP cases.
Intravescial hemolock clip migration after LRP is associated with 3 causes:
- Obstructive lower urinary tract symptoms
- Stone formations, gross hematuria, bladder spasm
- Spontaneous expulsion of the clip.
Up to 50% of lymphoceles are asymptomatic, and 1.7%+/-1.2 are symptomatic, causing compression of veins, nerves and even cause infection. It is important to remove all the lymph nodes that are involved with cancer. Lymphocele is usually formed since lymph nodes not associated to the cancer were removed. In the transperitoneal approach, the exposure is better and there are less lymphoceles.
When compared to the LRP, the open radical prostatectomy (ORP) has a higher transfusion rate (20.8% vs. 2.7%, p<0.001), and higher anastomotic strictures (14% vs. 5.8%, p<0.01). Independent risk factors for anastomotic strictures include previous radiotherapy and TURP procedure.
In conclusions, there are plenty of potential complications in LRP, but in general the complication rate is low. Knowing the possible complications is a prerequisite to avoid them.
Presented by: Gunter Janetschek, Salsburg/Vienna, Austria
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, twitter: @GoldbergHanan at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark