Mp69-19 Incidence, Risk Factors and Outcomes for Rectal Injury During Radical Prostatectomy
Year: 2016
Type: article
Study design: Observational Study
Abstract: INTRODUCTION AND OBJECTIVES: Rectal injury (RI) is a rare, but serious complication of radical prostatectomy (RP).We performed a population-based analysis of RI during RP.METHODS: The National Inpatient Sample (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012) was used to identify patients with a diagnosis of prostate cancer who underwent RP.Survey-weighted cohorts were created based on the diagnosis and repair of a RI.Data included demographics, hospital characteristics, hospital volume for RP, surgical details, complications and perioperative outcomes.Multivariable logistic regression was used to identify risk factors for RI.RESULTS: Of 614,294 men who underwent RP, there were 2900 (0.5%) RIs, with decreased incidence over time (0.6% in 2003 vs. 0.4% in 2012, p¼0.02).Colostomy was performed in 281 patients (10%).Patients with RI were slightly older (mean age 62.0 vs. 61.2,p<0.01) and RI was more frequent among African-Americans (0.8% vs 0.4% for Caucasians, p<0.01).There was no difference in Elixhauser comorbidity score between groups (p¼0.2).However, the incidence of RI was higher in patients with clinically significant benign prostatic hyperplasia (BPH) and metastatic disease and lower in obese men (all p<0.05).The overall incidence of RI was highest for open RP (0.6%) compared to laparoscopic (0.4%) and robotic approaches (0.2%), p<0.01.RI was also more common at urban (0.8% vs 0.5% for rural), non-teaching (0.6% vs 0.4% for teaching), and low-volume hospitals (0.6% vs 0.3% for high-volume), (all p<0.01).Overall complication rate (28% vs 11%, p<0.01), length of stay (4.8 vs 2.3 days, p<0.01), and total charges ($45,298 vs $32,855, p<0.01) were greater for patients with RI compared to those without.Multivariable logistic regression (see Table ) identified African-American race, BPH and metastatic cancer as predictors for RI, while private insurance, robotic approach, high-volume hospital and obesity reduced the risk of RI (all p<0.05).CONCLUSIONS: RI during RP is a rare complication, more common among African-Americans, patients with low BMI, BPH or with metastatic disease.RI was also more common for open surgical approaches and low-volume hospitals.
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2315868851