Laparoscopic and robotic radical prostatectomy outcomes in obese and extremely obese men.
Objective: To evaluate the operative and pathologic outcomes of laparoscopic radical prostatectomy and robot-assisted radical prostatectomy in men with progressive changes in body mass index (BMI) category.Materials and Methods: A single-surgeon series of 1023 laparoscopic radical prostatectomy and...
| Publicado en: | Urology Vol. 82; no. 3; pp. 600 - 606 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Sep2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104091515&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104091515 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00904295 1YG jtl: Urology issn: 00904295 maglogo: N pubinfo: dt: Sep2013 vid: 82 iid: 3 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 104091515 NLM23859532 2012244291 10.1016/j.urology.2013.05.013 NLM23859532 PMC3758791 104091515 ppf: 600 ppct: 6 formats: tig: atl: Laparoscopic and robotic radical prostatectomy outcomes in obese and extremely obese men. aug: au: Sundi, Debasish Reese, Adam C Mettee, Lynda Z Trock, Bruce J Pavlovich, Christian P affil: James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD. Electronic address: dsundi1@jhmi.edu. sug: subj: Body Mass Index Lymph Node Excision Obesity Complications Prostatectomy Methods Prostatic Neoplasms Pathology Prostatic Neoplasms Surgery Blood Loss, Surgical Human Laparoscopy Adverse Effects Length of Stay Male Middle Age Neoplasm Staging Neoplastic Processes Obesity, Morbid Complications Therapeutics Pelvis Prostate-Specific Antigen Blood Prostatectomy Adverse Effects Prostatic Neoplasms Blood Retrospective Design Robotics Treatment Outcomes Middle Aged: 45-64 years Male ab: Objective: To evaluate the operative and pathologic outcomes of laparoscopic radical prostatectomy and robot-assisted radical prostatectomy in men with progressive changes in body mass index (BMI) category.Materials and Methods: A single-surgeon series of 1023 laparoscopic radical prostatectomy and robot-assisted radical prostatectomy (mostly extraperitoneal) patients was considered. Of these patients, 987 were evaluable. Results were stratified by the World Health Organization BMI category. Multivariate linear and logistic regression analysis was used to model the operating time, length of stay, positive surgical margins, and noncurable cancer.Results: Of the 987 patients, 563 (57%) were overweight and 193 (19.6%) were obese. Of the 193 obese patients, 152 (15.4%) had a BMI of 30 to <35 kg/m(2) (class I obesity), 28 (2.8%) a BMI of 35 to <40 kg/m(2) (class II), and 13 (1.3%) a BMI of ≥40 kg/m(2) (class III). No differences were found in the estimated blood loss, complications, PSM, pathologic stage, or biochemical recurrence across the BMI categories (6-month median follow-up). However, pelvic lymph node dissection was more commonly omitted and the nerve-sparing score was inferior in the obese men. On multivariate analysis, a higher BMI was a significant predictor of a longer operating time.Conclusion: Obese men can safely undergo laparoscopic radical prostatectomy or robot-assisted radical prostatectomy, although the ability to perform excellent nerve sparing appears to decrease with increasing obesity. Nevertheless, obese men can expect perioperative and early oncologic outcomes comparable to those of normal weight men without an increased risk of perioperative complications. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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