EAU 2018: Obese Patients Undergoing Robotic Radical Prostatectomy Have No Impaired Operative Outcome
A total of 507 robotic-assisted radical prostatectomies (RARP) performed in a single robotic center from September 2009 to December 2014 were analyzed retrospectively. There were 97/507 (19%) obese patients with a median age of 65.7 years compared to 410/507 (81%) men with a BMI lower than 30, aged 66.0 years. Early postoperative complications (within 30 days after surgery) were classified using the Clavien-Dindo grading system.
There were no significant differences in age (p=0.64), preoperative PSA value (p=0.75), pre-existing erectile dysfunction (p=0.41), intraoperative complications (n= 2 vs. 8, p=0.1) or length of hospital stay (median for both groups 8 days, p=0.69) between the two groups. Non-parametrical analysis showed a longer operation time (median 200 vs. 180 minutes, p=0.001) in obese patients and a higher blood loss (median 300 ml vs. 200 ml, p=0.005). Only in 4 non- obese patients blood transfusions were given, all of them after surgery. High BMI had no significant impact on pT staging (p=0.64), anastomotic leakage (p=0.81), lymphoceles (p=0.58) or admission to intensive care unit (p=0.27). There was no significance in unplanned readmission within 30 days after surgery (14.3% vs. 8.0%, p=0.11).
However, significantly more urinary tract infections in patients with BMI over 30 were noted (20.4% vs. 9.2%, p=0.002). Diabetes showed a significant association with BMI over 30 (p= <0.001) but not with UTI (p=1). Early complications using the Clavien-Dindo-Grading system did not differ between the groups. The independence of urinary tract infections, higher blood loss and operative time from other parameters was confirmed in a multivariable logistic regression analysis.
These data suggest that obese patients with a BMI of over 30, who are undergoing RARP, have no impaired operative outcome. Obese patients have no overall increase of severity and amount of complications based on the Clavien-Dindo grading system, except for urinary tract infections.
Presented by: Neuenschwander J, Kantonsspital Winterthur, Dept. of Urology, Winterthur, Switzerland
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