Complications of Radical Prostatectomy Relate to Risk Stratification of prostate cancer Patients
Chi-rei Yang MD
Department of Urology, China Medical University Hospital, Taichung, Taiwan
Objectives: To analyze, classified and report a single surgeon experience of perieoperative complications of open radical prostatectomy associated with risk classification of prostate cancer.
Materials and Methods: Between 1984 and 2011, a total of 305 patients receiving open radical prostatectomy were evaluated for surgery related complications. Patient’s age ranged from 43 to 78 with a mean age of 68.5. Complications were classified into intra-operative, postoperative (<30 days) and late (>30 days). The Modified Claverin system was used to grade complications.
Results: Of 305 patients, 34 (11.2 %) had record of surgery related complications those including: 9 (2.7 %) intra-operative recognized, 19 (6.1%) postoperative and 7 (2.3) happened post discharge complications. Intra-operative complications were all grade 3 (All 7 rectum injury were recognized in operation and 6 of them were resolved by simple two layers sutures and another one had proximal colon diversion. Intra-operative bleeding was also analyzed. The mean blood loss was calculated as 1214 ml for first 100 cases, 960 ml for 2nd 100 cases and 880 ml for recent 105 cases, The blood transfusion rate were 76 %, 65 % and 57 % respectively. Of 34 complications, 5 (1.7%) were Clavein grade 1, 9 (2.9%) were grade 2, 16 (5.2%) were grade 3 and one grade 4 .One grade V (Mortality). Major complications (grade3/4) occurred in 10 % in first 100 cases and 80% of them were high risk patients. However major complications happened in 3.8% in recent 105 cases and all of them were high risk patients. . .
Conclusions: Radical prostatectomy is associated with major complications rate of 5.9 %. Almost of these complications were correctable if detected early, The operation mortality was 0.3%. Major complications are voluntary occurred in high risk patients suggest extended node dissection with wider excision of peri-prostate tissue may responsible for higher complications.