Journal article
Incidence, Risk Factors, and Outcomes for Rectal Injury During Radical Prostatectomy: A Population-based Study
European urology oncology, Vol.1(6), pp.501-506
12/2018
DOI: 10.1016/j.euo.2018.06.001
PMID: 31158094
Abstract
Rectal injury (RI) is a rare but potentially serious complication of radical prostatectomy (RP). Current evidence is limited owing to relatively small cohorts from select, tertiary referral centers.
To evaluate the incidence of and potential risk factors for RI during radical RP at a population level in the USA.
Using the National Inpatient Sample database (2003–2012), we identified patients with prostate cancer who underwent RP. Survey-weighted cohorts were created based on the diagnosis and repair of RI during initial hospitalization. Data included demographics, hospital characteristics, surgical details, complications, and perioperative outcomes. Multivariable logistic regression was used to identify risk factors for RI.
Of 614 294 men who underwent RP, there were 2900 (0.5%) RIs, with a 26% decline from 2003–2006 to 2009–2012 (p<0.01). Patients with RI were slightly older (62.0 vs 61.2 yr; p<0.01) and more commonly of African ancestry (0.8% vs 0.4% Caucasians; p<0.01). RI was more common among patients with benign prostatic hyperplasia (BPH), metastatic disease, and low body mass index (BMI; p<0.05). The RI incidence was higher for open (0.6%) compared to laparoscopic (0.4%) and robotic RP (0.2%; p<0.01). RI was more common at rural (0.8% vs 0.5% urban), nonteaching (0.6% vs 0.4% teaching), and low-volume hospitals (0.6% vs 0.3% high-volume; p<0.01). Complication rates (28% vs 11%; p<0.01) and length of stay (4.8 vs 2.3 d; p<0.01) were greater in the RI group. Multivariable analysis identified African ancestry, BPH, and metastatic cancer as predictors of RI, while robotic approach, high-volume hospital, and obesity reduced the risk (p<0.05).
RI during RP is a rare complication, but is more common among men with African ancestry and for procedures carried out using an open surgical technique or in low-volume hospitals, and among those with low BMI, BPH, or metastatic disease.
In a large US population, we found that rectal injury (RI) is a rare complication of radical prostatectomy, and that the risk of RI can increase according to patient- and hospital-specific characteristics.
Rectal injury (RI) occurs in approximately 0.5% of men undergoing radical prostatectomy (RP). The risk of RI is higher among men of African ancestry, those with benign prostatic hyperplasia, metastatic disease, or low body mass index, and those undergoing open RP or operated on in low-volume hospitals.
Details
- Title: Subtitle
- Incidence, Risk Factors, and Outcomes for Rectal Injury During Radical Prostatectomy: A Population-based Study
- Creators
- Nimrod S. Barashi - University of ChicagoShane M. Pearce - University of Southern CaliforniaAndrew J. Cohen - University of ChicagoJoseph J. Pariser - University of MinnesotaVignesh T. Packiam - University of ChicagoScott E. Eggener - University of Chicago
- Resource Type
- Journal article
- Publication Details
- European urology oncology, Vol.1(6), pp.501-506
- Publisher
- Elsevier B.V
- DOI
- 10.1016/j.euo.2018.06.001
- PMID
- 31158094
- ISSN
- 2588-9311
- eISSN
- 2588-9311
- Language
- English
- Date published
- 12/2018
- Academic Unit
- Urology
- Record Identifier
- 9984320076402771
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