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Comparison of transfusion requirements between open and robotic‐assisted laparoscopic radical prostatectomy
Author(s) -
Kordan Yakup,
Barocas Daniel A.,
Altamar Hernan O.,
Clark Peter E.,
Chang Sam S.,
Davis Rodney,
Herrell S. Duke,
Baumgartner Roxy,
Mishra Vineet,
Chan Robert C.,
Smith Jr Joseph A.,
Cookson Michael S.
Publication year - 2010
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/j.1464-410x.2010.09233.x
Subject(s) - medicine , blood transfusion , laparoscopic radical prostatectomy , odds ratio , univariate analysis , prostatectomy , confidence interval , urology , demographics , subgroup analysis , cohort , multivariate analysis , surgery , prostate cancer , cancer , demography , sociology
Study Type – Therapy (individual cohort)
Level of Evidence 2b OBJECTIVE To determine whether robotic‐assisted laparoscopic radical prostatectomy (RALP) is associated with a lower transfusion rate than radical retropubic prostatectomy (RRP). PATIENTS AND METHODS In this cohort study, we evaluated 1244 consecutive patients who underwent RALP (830) or RRP (414) between June 2003 and July 2006. Demographics, clinical characteristics, pathology, blood loss and transfusion data were collected prospectively. Groups were compared for baseline characteristics, blood loss, change in haematocrit and transfusion using univariate statistics, and an exploratory multivariate model was developed. RESULTS RALP was associated with lower blood loss (median 100 vs 450 mL, P < 0.001) and a smaller change in haematocrit (median 7% vs 10%, P < 0.001) than RRP. Although both groups had low transfusion rates, the RALP group required fewer transfusions than the RRP group (0.8% vs 3.4%, P = 0.002). On univariate analysis, surgical approach (RRP vs RALP), estimated blood loss ≥500 mL and change in haematocrit ≥10% were the only the significant predictors of transfusion. In the exploratory multivariate model RALP was the only significant predictor of reduced need for transfusion, with an odds ratio of 0.23 (95% confidence interval 0.09–0.58; P = 0.002). CONCLUSIONS This study shows that RALP is associated not only with less blood loss and a smaller decrease in haematocrit, but also a decreased need for transfusion.