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01-12-2024 | Prostatectomy | Research

Extended pelvic lymph node dissection in robot-assisted radical prostatectomy is an independent risk factor for major complications

Authors: Diederik J. H. Baas, Joost M. S. de Baaij, J. P. Michiel Sedelaar, Robert J. Hoekstra, Henricus J. E. J. Vrijhof, Diederik M. Somford, Jean-Paul A. van Basten

Published in: Journal of Robotic Surgery | Issue 1/2024

Abstract

The aim of this study is to evaluate the major postoperative complication rate after robot-assisted radical prostatectomy (RARP) and to identify related risk factors. A consecutive series of patients who underwent RARP between September 2016 and May 2021, with or without extended pelvic lymph node dissection (ePLND) were analyzed for postoperative complications that occurred within 30 days following surgery. Potential risk factors related to complications were identified by means of a multivariate logistic analysis. Electronic medical records were retrospectively reviewed for the occurrence of major complications (Clavien–Dindo grade III or higher) on a per patient level. A multivariate logistic regression with risk factors was performed to identify contributors to complications. In total, 1280 patients were included, of whom 79 (6.2%) experienced at least 1 major complication. Concomitant ePLND was performed in 609 (48%) of patients. The majority of all complications were likely related to the surgical procedure, with anastomotic leakage and lymphoceles being the most common. Upon multivariate analysis, performing ePLND remained the only significant risk factor for the occurrence of major complications (OR 2.26, p = 0.001). In contrast to robot-assisted radical prostatectomy alone, the combination with extended pelvic lymph node dissection (ePLND) has a substantial risk of serious complications. Since the ePLND is performed mainly for staging purpose, the clinical contribution of the ePLND has to be reconsidered with the present use of the PSMA-PET/CT.

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Title: Extended pelvic lymph node dissection in robot-assisted radical prostatectomy is an independent risk factor for major complications
Authors: Diederik J. H. Baas
Joost M. S. de Baaij
J. P. Michiel Sedelaar
Robert J. Hoekstra
Henricus J. E. J. Vrijhof
Diederik M. Somford
Jean-Paul A. van Basten
Publication date: 01-12-2024
Publisher: Springer London
Keywords: Prostatectomy
Prostatectomy
Prostate Cancer
Prostate Cancer
Published in: Journal of Robotic Surgery / Issue 1/2024
Print ISSN: 1863-2483
Electronic ISSN: 1863-2491
DOI: https://doi.org/10.1007/s11701-024-01881-2

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Extended pelvic lymph node dissection in robot-assisted radical prostatectomy is an independent risk factor for major complications

Abstract

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Abstract

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