Document Detail


Comparison of transfusion requirements between open and robotic-assisted laparoscopic radical prostatectomy.
MedLine Citation:
PMID:  20151960     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether robotic-assisted laparoscopic radical prostatectomy (RALP) is associated with a lower transfusion rate than radical retropubic prostatectomy (RRP).
PATIENTS AND METHODS: In this cohort study, we evaluated 1244 consecutive patients who underwent RALP (830) or RRP (414) between June 2003 and July 2006. Demographics, clinical characteristics, pathology, blood loss and transfusion data were collected prospectively. Groups were compared for baseline characteristics, blood loss, change in haematocrit and transfusion using univariate statistics, and an exploratory multivariate model was developed.
RESULTS: RALP was associated with lower blood loss (median 100 vs 450 mL, P < 0.001) and a smaller change in haematocrit (median 7% vs 10%, P < 0.001) than RRP. Although both groups had low transfusion rates, the RALP group required fewer transfusions than the RRP group (0.8% vs 3.4%, P= 0.002). On univariate analysis, surgical approach (RRP vs RALP), estimated blood loss ≥500 mL and change in haematocrit ≥10% were the only the significant predictors of transfusion. In the exploratory multivariate model RALP was the only significant predictor of reduced need for transfusion, with an odds ratio of 0.23 (95% confidence interval 0.09-0.58; P= 0.002).
CONCLUSIONS: This study shows that RALP is associated not only with less blood loss and a smaller decrease in haematocrit, but also a decreased need for transfusion.
Authors:
Yakup Kordan; Daniel A Barocas; Hernan O Altamar; Peter E Clark; Sam S Chang; Rodney Davis; S Duke Herrell; Roxy Baumgartner; Vineet Mishra; Robert C Chan; Joseph A Smith; Michael S Cookson
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-02-11
Journal Detail:
Title:  BJU international     Volume:  106     ISSN:  1464-410X     ISO Abbreviation:  BJU Int.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-06     Completed Date:  2010-11-03     Revised Date:  2011-04-05    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  1036-40     Citation Subset:  IM    
Copyright Information:
© 2010 THE AUTHORS. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL.
Affiliation:
Vanderbilt University Medical Center, Department of Urologic Surgery, Nashville, TN 37205, USA.
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MeSH Terms
Descriptor/Qualifier:
Blood Loss, Surgical / statistics & numerical data*
Blood Transfusion / statistics & numerical data*
Cohort Studies
Hematocrit / statistics & numerical data
Humans
Laparoscopy*
Male
Middle Aged
Multivariate Analysis
Prostatectomy / methods*
Prostatic Neoplasms / surgery*
Robotics*
Comments/Corrections
Comment In:
BJU Int. 2011 Mar;107(5):853-4; author reply 854   [PMID:  21355986 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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