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Open Access 13-07-2022 | Prostate Cancer | Original Article

American Society of Anesthesiologists’ (ASA) Physical Status System and Risk of Major Clavien-Dindo Complications After Robot-Assisted Radical Prostatectomy at Hospital Discharge: Analysis of 1143 Consecutive Prostate Cancer Patients

Authors: Antonio Benito Porcaro, Riccardo Rizzetto, Nelia Amigoni, Alessandro Tafuri, Alberto Bianchi, Sebastian Gallina, Rossella Orlando, Emanuele Serafin, Alessandra Gozzo, Clara Cerrato, Giacomo Di Filippo, Filippo Migliorini, Stefano Zecchini Antoniolli, Giovanni Novella, Vincenzo De Marco, Matteo Brunelli, Maria Angela Cerruto, Enrico Polati, Alessandro Antonelli

Published in: Indian Journal of Surgical Oncology | Issue 4/2022

Abstract

Objective

To test the hypothesis of associations of preoperative physical status system with major postoperative complications at hospital discharge in prostate cancer (PCa) patients treated with robot-assisted radical prostatectomy (RARP).

Materials and Methods

In a period ranging from January 2013 to October 2020, 1143 patients were evaluated. The physical status was assessed by the American Society of Anesthesiologists’ (ASA) system, which was computed trained anesthesiologists. The Clavien-Dindo system was used to classify postoperative complications, which were coded as major if greater than 1.

Results

ASA physical status system included class I in 102 patients (8.9%), class II in 934 subjects (81.7%), and class III in 107 cases (9.4%). Clavien-Dindo complications were distributed as follows: grade 1: 141 cases (12.3%), grade 2: 108 patients (9.4%), grade 3a: 5 subjects (0.4%), grade 3b: 9 patients (0.8%), and grade 4a: 3 cases (0.3%). Overall, major complications were detected in 125 cases (10.9%). On multivariate analysis, major Clavien-Dindo complications were predicted by ASA score grade II (adjusted odds ratio, OR = 2.538; 95%CI 1.007–6.397; p = 0.048) and grade III (adjusted OR 3.468; 95%CI 1.215–9.896; p = 0.020) independently by pelvic lymph node dissection (PLND) and/or blood lost.

Conclusion

In RARP surgery, the risk of major postoperative Clavien-Dindo complications increased as the physical status system deteriorated independently by performing or not a PLND and/or large intraoperative blood lost. The ASA score system was an effective predictor of major Clavien-Dindo complications, which delayed LOHS in RARP surgery. Confirmatory studies are required.

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Title: American Society of Anesthesiologists’ (ASA) Physical Status System and Risk of Major Clavien-Dindo Complications After Robot-Assisted Radical Prostatectomy at Hospital Discharge: Analysis of 1143 Consecutive Prostate Cancer Patients
Authors: Antonio Benito Porcaro
Riccardo Rizzetto
Nelia Amigoni
Alessandro Tafuri
Alberto Bianchi
Sebastian Gallina
Rossella Orlando
Emanuele Serafin
Alessandra Gozzo
Clara Cerrato
Giacomo Di Filippo
Filippo Migliorini
Stefano Zecchini Antoniolli
Giovanni Novella
Vincenzo De Marco
Matteo Brunelli
Maria Angela Cerruto
Enrico Polati
Alessandro Antonelli
Publication date: 13-07-2022
Publisher: Springer India
Keywords: Prostate Cancer
Prostate Cancer
Prostatectomy
Prostatectomy
Published in: Indian Journal of Surgical Oncology / Issue 4/2022
Print ISSN: 0975-7651
Electronic ISSN: 0976-6952
DOI: https://doi.org/10.1007/s13193-022-01577-9

At a glance: The STEP trials

Springer Medicine

American Society of Anesthesiologists’ (ASA) Physical Status System and Risk of Major Clavien-Dindo Complications After Robot-Assisted Radical Prostatectomy at Hospital Discharge: Analysis of 1143 Consecutive Prostate Cancer Patients

Abstract

Objective

Materials and Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Materials and Methods

Results

Conclusion

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