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Postoperative complications of contemporary open and robot‐assisted laparoscopic radical prostatectomy using standardised reporting systems
Author(s) -
Pompe Raisa S.,
Beyer Burkhard,
Haese Alexander,
Preisser Felix,
Michl Uwe,
Steuber Thomas,
Graefen Markus,
Huland Hartwig,
Karakiewicz Pierre I.,
Tilki Derya
Publication year - 2018
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.14369
Subject(s) - medicine , complication , logistic regression , prostatectomy , incidence (geometry) , laparoscopic radical prostatectomy , surgery , general surgery , prostate cancer , cancer , physics , optics
Objectives To analyse time trends and contemporary rates of postoperative complications after radical prostatectomy ( RP ) and to compare the complication profile of open RP ( ORP ) and robot‐assisted laparoscopic RP ( RALP ) using standardised reporting systems. Patients and Methods Retrospective analysis of 13 924 RP patients in a single institution (2005–2015). Complications were collected during hospital stay and via standardised questionnaire 3 months after, and grouped into eight schemes. Since 2013, the revised Clavien–Dindo classification was used ( n = 4 379). Annual incidence rates of different complications were graphically displayed. Multivariable logistic regression analyses compared complications between ORP and RALP after inverse probability of treatment weighting ( IPTW ). Results After the introduction of standardised classification systems, complication rates have increased with a contemporary rate of 20.6% (2013–2015). While minor Clavien–Dindo grades represented the majority (I: 10.6%; II : 7.9%), severe complications (Grades IV –V) were rare (<1%). In logistic regression analyses after IPTW , RALP was associated with less blood loss, shorter catheterisation time, and lower risk of Clavien–Dindo Grade II and III complications. Conclusion Our results emphasise the importance of standardised reporting systems for quality control and comparison across approaches or institutions. Contemporary complication rates in a high‐volume centre remain low and are most frequently minor Clavien–Dindo grades. RALP had a slightly better complication profile compared to ORP .