Comparison of complications after open and laparoscopic radical prostatectomies
Csaba Berczi dr., Dócs János dr., Flaskó Tibor dr.
Debreceni Egyetem, Általános Orvostudományi Kar, Urológiai Tanszék, Debrecen (igazgató: Flaskó Tibor dr.)
Objective: The authors compared the incidence of complications following open and laparoscopic radical prostatectomies for prostate tumors at their institute.
Material and methods: Data of 871 patients were assessed who underwent radical prostatectomy for prostate cancer from January 2015 to January 2020. In group 1 (n: 707) the patients underwent laparoscopic and in group 2 (n: 164) the patients underwent open retropubic radical prostatectomy. The mean age of the patients was 65.6±6.3 years and the mean PSA level was 13.1±13.0 ng/ml. The Clavien–Dindo classification was applied to classify the complications.
Results: In the early postoperative period in group 1, grade 1+2 complications occurred in 91 cases (12.8%) while grade 3+4 complications occurred in 19 patients (2.6%) according to Clavien–Dindo classification. In group 2, there were 91 (55.4%) grade 1+2 complications and 9 (5.4%) Grade 3+4 complications according to Clavien–Dindo classification. The incidence of grade 1+2 complications was significantly (p <0.0001), while the incidence of grade 3+4 complications was not significantly (p=0.138) higher in the open surgical group.
In the late postoperative period in group 1 grade 1+2 complications developed in 11 occasions (1.5%) and grade 3+4 complications in 12 patients (1.7%). In Group 2, grade 1+2 complications occurred in 5 cases (3.0%) while grade 3+4 complications occurred 7 in patients (4.2%) according to Clavien–Dindo classification. Regarding to late complication rates, there was no significant difference between groups 1 and 2 neither grade 1+2 nor grade 3+4 complications (p=0.346 and p=0.122).
Conclusions: Based on the results, it can be concluded that postoperative complications were significantly more common in patients those who underwent open surgery. However, a significant difference was found only in the case of early complications, in mild – grade 1+2- forms, between the two groups.