Comprehensive standardized report of complications of retropubic and laparoscopic radical prostatectomy Journal Article


Authors: Rabbani, F.; Yunis, L. H.; Pinochet, R; Nogueira, L.; Vora, K. C.; Eastham, J. A.; Guillonneau, B.; Laudone, V.; Scardino, P. T.; Touijer, K.
Article Title: Comprehensive standardized report of complications of retropubic and laparoscopic radical prostatectomy
Abstract: Background: The lack of standardized reporting of the complications of radical prostatectomy in the literature has made it difficult to compare incidences across institutions and across different surgical approaches. Objective: To define comprehensively the incidence, severity, and timing of onset of medical and surgical complications of open retropubic prostatectomy (RP) and laparoscopic radical prostatectomy (LP) using a standardized reporting methodology to facilitate comparison. Design, setting, and participants: Between January 1999 and June 2007, 4592 consecutive patients underwent RP or LP without prior radiation or hormonal therapy. Median follow-up was 36.9 mo (interquartile range: 20.3-60.6). Intervention: Open or laparoscopic radical prostatectomy. Measurements: All medical and surgical complications of radical prostatectomy were captured and graded according to the modified Clavien classification and classified by timing of onset. Results and limitations: There were 612 medical complications in 467 patients (10.2%) and 1426 surgical complications in 925 patients (20.1%). The overall incidences of early minor and major medical and surgical complications for RP were 8.5% and 1.5% for medical and 11.4% and 4.9% for surgical complications, respectively. The overall incidences of early minor and major medical and surgical complications for LP were 14.2% and 2.3% for medical and 23.1% and 6.6% for surgical complications, respectively. On multivariate analysis, LP approach was associated with a higher incidence of any grade medical and surgical complications but a lower incidence of major surgical complications than RP. Six hundred fifty-two men (14.2%) visited the emergency department, and 240 men (5.2%) required readmission. The main limitation is the retrospective nature. Conclusions: With standardized reporting, the incidence of some complications is higher than recognized in the literature. Although most complications are minor in severity, medical and surgical complications are observed in approximately 10% and 20% of patients, respectively. Accurate reporting of complications through a standardized methodology is essential for counseling patients regarding risk of complications, for identifying modifiable risk factors, and for facilitating comparison across institutions and approaches. © 2009 European Association of Urology.
Keywords: adult; middle aged; cancer surgery; surgical technique; retrospective studies; major clinical study; follow up; laparoscopy; laparoscopic surgery; adenocarcinoma; incidence; risk factors; surgical approach; time factors; prostate cancer; postoperative complication; postoperative complications; prostatic neoplasms; standard; disease severity; severity of illness index; prostatectomy; comorbidity; complications; hospital readmission; medical records
Journal Title: European Urology
Volume: 57
Issue: 3
ISSN: 0302-2838
Publisher: Elsevier Science, Inc.  
Date Published: 2010-03-01
Start Page: 371
End Page: 386
Language: English
DOI: 10.1016/j.eururo.2009.11.034
PUBMED: 19945779
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 12" - "Export Date: 20 April 2011" - "CODEN: EUURA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Vincent Laudone
    59 Laudone
  2. Peter T Scardino
    615 Scardino
  3. Farhang Rabbani
    82 Rabbani
  4. Abdelkrim Karim Touijer
    190 Touijer
  5. James Eastham
    422 Eastham
  6. Kinjal C Vora
    25 Vora