TY - JOUR
T1 - Perioperative management of radical prostatectomy
T2 - A nationwide survey in Japan
AU - Okamura, Kikuo
AU - Tsushima, Tomoyasu
AU - Kawakita, Mutsushi
AU - Nojiri, Yoshikatsu
AU - Naito, Seiji
AU - Matsuda, Tadashi
AU - Hattori, Ryohei
AU - Hasegawa, Tomonori
AU - Kaiho, Yasuhiro
AU - Arai, Yoichi
PY - 2011/11
Y1 - 2011/11
N2 - (Purpose) Recently, various types of radical surgery have been performed in Japan. To elucidate the surgical consequences, morbidity and mortality, and perioperative care, we conducted a nationwide survey. (Materials and methods) Assisted by the Japanese Society of Endourology, perioperative data from 156 hospitals participating in this survey in 2007 were analyzed. Using a spreadsheet database, data were collected from each institution. (Results) Open radical prostatectomy was performed in 3,138 patients at 143 hospitals, minimum incision endourological radical prostatectomy in 361 at 15 hospitals, laparoscopic radical prostatectomy via transperitoneal approach in 143 at 11 hospitals and laparoscopic radical prostatectomy via extraperitoneal approach in 337 at 13 hospitals. For open and minimum incision endourological radical prostatectomy, the surgical duration was shorter but the bleeding volume was greater than that in laparoscopic radical prostatectomy via both approaches. As a whole, perioperatvie mortality rate was 0.05% and morbidity rate was 23.4%. Rectal injury was similarly infrequent among the four types of surgery. Superficial surgical site infection was most frequent in open radical prostatectomy. Perioperative management significantly varied among the four types of surgery. In laparoscopic radical prostatectomy via extraperitoneal approach, urethral catheter was removed earlier but acute urinary retention frequently occurred. (Conclusions) In Japan, open radical prostatectomy was the most frequently performed surgery for prostate cancer. Surgical volume per hospital was small, however, mortality was low and morbidity was acceptable. Comparisons of complications and outcomes among the types of currently performed surgery should be useful to promote standardization of the perioperative care.
AB - (Purpose) Recently, various types of radical surgery have been performed in Japan. To elucidate the surgical consequences, morbidity and mortality, and perioperative care, we conducted a nationwide survey. (Materials and methods) Assisted by the Japanese Society of Endourology, perioperative data from 156 hospitals participating in this survey in 2007 were analyzed. Using a spreadsheet database, data were collected from each institution. (Results) Open radical prostatectomy was performed in 3,138 patients at 143 hospitals, minimum incision endourological radical prostatectomy in 361 at 15 hospitals, laparoscopic radical prostatectomy via transperitoneal approach in 143 at 11 hospitals and laparoscopic radical prostatectomy via extraperitoneal approach in 337 at 13 hospitals. For open and minimum incision endourological radical prostatectomy, the surgical duration was shorter but the bleeding volume was greater than that in laparoscopic radical prostatectomy via both approaches. As a whole, perioperatvie mortality rate was 0.05% and morbidity rate was 23.4%. Rectal injury was similarly infrequent among the four types of surgery. Superficial surgical site infection was most frequent in open radical prostatectomy. Perioperative management significantly varied among the four types of surgery. In laparoscopic radical prostatectomy via extraperitoneal approach, urethral catheter was removed earlier but acute urinary retention frequently occurred. (Conclusions) In Japan, open radical prostatectomy was the most frequently performed surgery for prostate cancer. Surgical volume per hospital was small, however, mortality was low and morbidity was acceptable. Comparisons of complications and outcomes among the types of currently performed surgery should be useful to promote standardization of the perioperative care.
KW - Perioperative care
KW - Radical prostatectomy
KW - Surgical outcome
UR - http://www.scopus.com/inward/record.url?scp=83155189814&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=83155189814&partnerID=8YFLogxK
U2 - 10.5980/jpnjurol.102.713
DO - 10.5980/jpnjurol.102.713
M3 - Review article
C2 - 22390085
AN - SCOPUS:83155189814
VL - 102
SP - 713
EP - 720
JO - Japanese Journal of Urology
JF - Japanese Journal of Urology
SN - 0021-5287
IS - 6
ER -