Intraoperative and postoperative complications of radical retropubic prostatectomy in a consecutive series of 1,000 cases

Weber K. Lau, Michael L. Blute, David G. Bostwick, Amy L. Weaver, Thomas J. Sebo, Horst Zincke

Research output: Contribution to journalArticle

249 Citations (Scopus)

Abstract

Purpose: We critically examined the intraoperative and postoperative complications associated with radical retropubic prostatectomy in the modern era. Materials and Methods: Between April 18, 1994 and July 13, 2000, 1,000 men underwent radical retropubic prostatectomy performed by a single surgeon. The whole inpatient hospital medical record of 909 patients, the outpatient charts of 955 and a self-administered patient survey completed by 679 were reviewed by 2 data managers not involved in surgical management or followup care. In all 1,000 cases at least 1 of the 3 data sources was reviewed. Results: Mean patient age was 60.3 years. In 73%, 99.8% and 95.7% of cases serum prostate specific antigen was 10 ng./ml, or less, disease was clinical stage T1 or T2 and Gleason score was 7 or less, respectively, while 19.9% of pathological specimens showed positive margins. There were 8 intraoperative complications (0.8%). All 5 rectal injuries and the single ureteral injury were detected during the initial surgical procedure and repaired without sequelae. Only 14 men (1.4%) had any other complications during hospitalization. Until postoperative day 30, 4 pulmonary emboli (0.4%) with or without deep vein thrombosis and 5 myocardial infarctions (0.5%) developed. There were no intraoperative or in-hospital postoperative deaths and only 1 postoperative death secondary to myocardial infarction during the initial 30 days. Reexploration was done for hemorrhage and a disrupted anastomosis in 3 and 2 cases, respectively. Mean hospitalization was 2.3 days, 9.7% of patients required allogenic blood transfusion and 15 (1.5%) were rehospitalized. Conclusions: Our series represents a rigorous assessment of the complications associated with radical retropubic prostatectomy. It shows that in the hands of an experienced urological surgeon, this procedure is associated with minimal intraoperative and postoperative morbidity. Of the patients 98% had no intraoperative or postoperative complications. Our series enables appropriate contemporary comparisons to be made with laparoscopic prostatectomy and radiation therapy. This outcomes analysis implies that radical retropubic prostatectomy cannot be assumed to have greater morbidity than radiation therapy and it sets a high standard for those advocating laparoscopic radical prostatectomy.

Original languageEnglish (US)
Pages (from-to)1729-1733
Number of pages5
JournalJournal of Urology
Volume166
Issue number5
StatePublished - 2001
Externally publishedYes

Fingerprint

Intraoperative Complications
Prostatectomy
Hospitalization
Radiotherapy
Myocardial Infarction
Morbidity
Hospital Records
Neoplasm Grading
Information Storage and Retrieval
Wounds and Injuries
Prostate-Specific Antigen
Embolism
Venous Thrombosis
Blood Transfusion
Medical Records
Inpatients
Outpatients
Hemorrhage
Lung
Serum

Keywords

  • Intraoperative complications
  • Postoperative complications
  • Prostate
  • Prostatectomy
  • Questionnaires

ASJC Scopus subject areas

  • Urology

Cite this

Lau, W. K., Blute, M. L., Bostwick, D. G., Weaver, A. L., Sebo, T. J., & Zincke, H. (2001). Intraoperative and postoperative complications of radical retropubic prostatectomy in a consecutive series of 1,000 cases. Journal of Urology, 166(5), 1729-1733.

Intraoperative and postoperative complications of radical retropubic prostatectomy in a consecutive series of 1,000 cases. / Lau, Weber K.; Blute, Michael L.; Bostwick, David G.; Weaver, Amy L.; Sebo, Thomas J.; Zincke, Horst.

In: Journal of Urology, Vol. 166, No. 5, 2001, p. 1729-1733.

Research output: Contribution to journalArticle

Lau, WK, Blute, ML, Bostwick, DG, Weaver, AL, Sebo, TJ & Zincke, H 2001, 'Intraoperative and postoperative complications of radical retropubic prostatectomy in a consecutive series of 1,000 cases', Journal of Urology, vol. 166, no. 5, pp. 1729-1733.
Lau, Weber K. ; Blute, Michael L. ; Bostwick, David G. ; Weaver, Amy L. ; Sebo, Thomas J. ; Zincke, Horst. / Intraoperative and postoperative complications of radical retropubic prostatectomy in a consecutive series of 1,000 cases. In: Journal of Urology. 2001 ; Vol. 166, No. 5. pp. 1729-1733.
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abstract = "Purpose: We critically examined the intraoperative and postoperative complications associated with radical retropubic prostatectomy in the modern era. Materials and Methods: Between April 18, 1994 and July 13, 2000, 1,000 men underwent radical retropubic prostatectomy performed by a single surgeon. The whole inpatient hospital medical record of 909 patients, the outpatient charts of 955 and a self-administered patient survey completed by 679 were reviewed by 2 data managers not involved in surgical management or followup care. In all 1,000 cases at least 1 of the 3 data sources was reviewed. Results: Mean patient age was 60.3 years. In 73{\%}, 99.8{\%} and 95.7{\%} of cases serum prostate specific antigen was 10 ng./ml, or less, disease was clinical stage T1 or T2 and Gleason score was 7 or less, respectively, while 19.9{\%} of pathological specimens showed positive margins. There were 8 intraoperative complications (0.8{\%}). All 5 rectal injuries and the single ureteral injury were detected during the initial surgical procedure and repaired without sequelae. Only 14 men (1.4{\%}) had any other complications during hospitalization. Until postoperative day 30, 4 pulmonary emboli (0.4{\%}) with or without deep vein thrombosis and 5 myocardial infarctions (0.5{\%}) developed. There were no intraoperative or in-hospital postoperative deaths and only 1 postoperative death secondary to myocardial infarction during the initial 30 days. Reexploration was done for hemorrhage and a disrupted anastomosis in 3 and 2 cases, respectively. Mean hospitalization was 2.3 days, 9.7{\%} of patients required allogenic blood transfusion and 15 (1.5{\%}) were rehospitalized. Conclusions: Our series represents a rigorous assessment of the complications associated with radical retropubic prostatectomy. It shows that in the hands of an experienced urological surgeon, this procedure is associated with minimal intraoperative and postoperative morbidity. Of the patients 98{\%} had no intraoperative or postoperative complications. Our series enables appropriate contemporary comparisons to be made with laparoscopic prostatectomy and radiation therapy. This outcomes analysis implies that radical retropubic prostatectomy cannot be assumed to have greater morbidity than radiation therapy and it sets a high standard for those advocating laparoscopic radical prostatectomy.",
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AU - Sebo, Thomas J.

AU - Zincke, Horst

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N2 - Purpose: We critically examined the intraoperative and postoperative complications associated with radical retropubic prostatectomy in the modern era. Materials and Methods: Between April 18, 1994 and July 13, 2000, 1,000 men underwent radical retropubic prostatectomy performed by a single surgeon. The whole inpatient hospital medical record of 909 patients, the outpatient charts of 955 and a self-administered patient survey completed by 679 were reviewed by 2 data managers not involved in surgical management or followup care. In all 1,000 cases at least 1 of the 3 data sources was reviewed. Results: Mean patient age was 60.3 years. In 73%, 99.8% and 95.7% of cases serum prostate specific antigen was 10 ng./ml, or less, disease was clinical stage T1 or T2 and Gleason score was 7 or less, respectively, while 19.9% of pathological specimens showed positive margins. There were 8 intraoperative complications (0.8%). All 5 rectal injuries and the single ureteral injury were detected during the initial surgical procedure and repaired without sequelae. Only 14 men (1.4%) had any other complications during hospitalization. Until postoperative day 30, 4 pulmonary emboli (0.4%) with or without deep vein thrombosis and 5 myocardial infarctions (0.5%) developed. There were no intraoperative or in-hospital postoperative deaths and only 1 postoperative death secondary to myocardial infarction during the initial 30 days. Reexploration was done for hemorrhage and a disrupted anastomosis in 3 and 2 cases, respectively. Mean hospitalization was 2.3 days, 9.7% of patients required allogenic blood transfusion and 15 (1.5%) were rehospitalized. Conclusions: Our series represents a rigorous assessment of the complications associated with radical retropubic prostatectomy. It shows that in the hands of an experienced urological surgeon, this procedure is associated with minimal intraoperative and postoperative morbidity. Of the patients 98% had no intraoperative or postoperative complications. Our series enables appropriate contemporary comparisons to be made with laparoscopic prostatectomy and radiation therapy. This outcomes analysis implies that radical retropubic prostatectomy cannot be assumed to have greater morbidity than radiation therapy and it sets a high standard for those advocating laparoscopic radical prostatectomy.

AB - Purpose: We critically examined the intraoperative and postoperative complications associated with radical retropubic prostatectomy in the modern era. Materials and Methods: Between April 18, 1994 and July 13, 2000, 1,000 men underwent radical retropubic prostatectomy performed by a single surgeon. The whole inpatient hospital medical record of 909 patients, the outpatient charts of 955 and a self-administered patient survey completed by 679 were reviewed by 2 data managers not involved in surgical management or followup care. In all 1,000 cases at least 1 of the 3 data sources was reviewed. Results: Mean patient age was 60.3 years. In 73%, 99.8% and 95.7% of cases serum prostate specific antigen was 10 ng./ml, or less, disease was clinical stage T1 or T2 and Gleason score was 7 or less, respectively, while 19.9% of pathological specimens showed positive margins. There were 8 intraoperative complications (0.8%). All 5 rectal injuries and the single ureteral injury were detected during the initial surgical procedure and repaired without sequelae. Only 14 men (1.4%) had any other complications during hospitalization. Until postoperative day 30, 4 pulmonary emboli (0.4%) with or without deep vein thrombosis and 5 myocardial infarctions (0.5%) developed. There were no intraoperative or in-hospital postoperative deaths and only 1 postoperative death secondary to myocardial infarction during the initial 30 days. Reexploration was done for hemorrhage and a disrupted anastomosis in 3 and 2 cases, respectively. Mean hospitalization was 2.3 days, 9.7% of patients required allogenic blood transfusion and 15 (1.5%) were rehospitalized. Conclusions: Our series represents a rigorous assessment of the complications associated with radical retropubic prostatectomy. It shows that in the hands of an experienced urological surgeon, this procedure is associated with minimal intraoperative and postoperative morbidity. Of the patients 98% had no intraoperative or postoperative complications. Our series enables appropriate contemporary comparisons to be made with laparoscopic prostatectomy and radiation therapy. This outcomes analysis implies that radical retropubic prostatectomy cannot be assumed to have greater morbidity than radiation therapy and it sets a high standard for those advocating laparoscopic radical prostatectomy.

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