Editor's Commentary - A population-based analysis of temporal perioperative complication rates after minimally invasive radical prostatectomy

BERKELEY, CA (UroToday.com) - In the online version of European Urology, an international group of investigators report on the temporal changes in complications following minimally invasive radical prostatectomy (MIRP).

They found a decrease during the period 2006-2007 compared with 2001-2005. The database was the Nationwide Inpatient Sample discharge records, from which between 2001 and 2007 4,387 patients with prostate cancer (CaP) were identified as having undergone MIRP. Complications were identified and defined using ICD-9 codes and hospital length of stay (LOS) was calculated.

Comparing the early period (2001-6) with the late period (2006-7), blood transfusion rates did not differ significantly but intra-operative complications decreased from 7.0% to 0.8%; bowel injury and nerve and/or vascular injury decreased from 3% to 0.2% and from 7% to 0.8%, respectively. Rates of post-operative complications decreased from 28.5% to 8.7%; respiratory and GU complications decreased from 3.5% to 1.4%, and from 5% to 1%, respectively. Miscellaneous medical and surgical complications decreased from 18.5% to 4.9% and from 9.5% to 2.1%, respectively. They also found that the proportion of patients with a LOS above the median decreased from 56% in 2001 to 15% in 2007. In the late study period, the rates of intra-operative complications were 2.2% compared with 0.8% for the early period and the overall postoperative complications decreased to 8.1% from 12.9%. LOS also decrease with 13.3% staying >2 days in the latter period compared with 26% in the early period. Multivariable analyses confirmed lower rates of intra-operative and post-operative complications in the late study period compared to the early study period with shorter LOS in excess of the median.

Schmitges J, Trinh QD, Abdollah F, Sun M, Bianchi M, Budäus L, Zorn K, Perotte P, Schlomm T, Haese A, Montorsi F, Menon M, Graefen M, Karakiewicz PI


Eur Urol. 2011 Sep;60(3):564-71

PubMed Abstract
PMID: 21723034

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