Reduction in postoperative ileus rates utilizing lower pressure pneumoperitoneum in robotic-assisted radical prostatectomy.

Matthew Rohloff, Arman Cicic, Cody Christensen, Thomas K Maatman, Jeffrey Lindberg, Thomas J Maatman
Author Information
  1. Matthew Rohloff: Department of Urological Surgery, Metro Health: University of Michigan Health, Grand Rapids, MI, USA. matthew.rohloff@metrogr.org. ORCID
  2. Arman Cicic: Department of Urological Surgery, Metro Health: University of Michigan Health, Grand Rapids, MI, USA.
  3. Cody Christensen: Department of Urological Surgery, Metro Health: University of Michigan Health, Grand Rapids, MI, USA.
  4. Thomas K Maatman: Department of Urological Surgery, Metro Health: University of Michigan Health, Grand Rapids, MI, USA.
  5. Jeffrey Lindberg: Department of Urological Surgery, Metro Health: University of Michigan Health, Grand Rapids, MI, USA.
  6. Thomas J Maatman: Department of Urological Surgery, Metro Health: University of Michigan Health, Grand Rapids, MI, USA.

Abstract

Robotic-assisted radical prostatectomy (RARP) is the most commonly performed surgery for prostate cancer. This is a study comparing differences in postoperative outcomes between pneumoperitoneum pressures of 15 mmHg and 12 mmHg. Retrospective chart review was performed on 400 patients undergoing RARP over a 5 year period. A combination of Fisher's exact test and ANOVA were utilized for statistical analysis. Age, BMI, Gleason score, positive margin rate, complication rates, blood loss, and operative times were similar in both groups. Length of stay and postoperative ileus rates were significantly less in the 12 mmHg group (p < 0.05). RARP can be safely performed utilizing a lower pressure pneumoperitoneum. Decreasing insufflation pressures from 15 to 12 mmHg can further lead to decreased rates of postoperative ileus.

Keywords

References

  1. Ther Clin Risk Manag. 2008 Oct;4(5):913-7 [PMID: 19209273]
  2. J Manag Care Pharm. 2009 Jul-Aug;15(6):485-94 [PMID: 19610681]
  3. J Am Coll Surg. 2010 Feb;210(2):228-31 [PMID: 20113944]
  4. J Urol. 2012 Jun;187(6):2087-92 [PMID: 22498227]
  5. J Gastrointest Surg. 2013 May;17(5):962-72 [PMID: 23377782]
  6. Cochrane Database Syst Rev. 2014 Mar 18;(3):CD006930 [PMID: 24639018]
  7. Rev Urol. 2013;15(4):178-84 [PMID: 24659914]
  8. Cent European J Urol. 2014;67(1):19-24 [PMID: 24982775]
  9. J Robot Surg. 2016 Sep;10(3):215-9 [PMID: 27059614]
  10. Prostate Cancer Prostatic Dis. 2017 Mar;20(1):117-121 [PMID: 28045114]
  11. J Am Coll Surg. 1997 Apr;184(4):378-82 [PMID: 9100683]

MeSH Term

Humans
Ileus
Insufflation
Male
Middle Aged
Pneumoperitoneum, Artificial
Postoperative Complications
Pressure
Prostatectomy
Prostatic Neoplasms
Retrospective Studies
Robotic Surgical Procedures
Treatment Outcome

Word Cloud

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