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Lymphocele after extraperitoneal robot-assisted radical prostatectomy: A propensity score-matching study

Authors
 Joo Yong Lee  ;  Richilda Red Diaz  ;  Kang Su Cho  ;  Ho Song Yu  ;  Jae Seung Chung  ;  Won Sik Ham  ;  Young Deuk Choi 
Citation
 INTERNATIONAL JOURNAL OF UROLOGY, Vol.20(12) : 1169-1176, 2013 
Journal Title
 INTERNATIONAL JOURNAL OF UROLOGY 
ISSN
 0919-8172 
Issue Date
2013
MeSH
Aged ; Drainage/methods ; Drainage/statistics & numerical data ; Follow-Up Studies ; Humans ; Incidence ; Lymph Node Excision/adverse effects ; Lymph Node Excision/statistics & numerical data ; Lymphocele/epidemiology* ; Lymphocele/etiology* ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Propensity Score ; Prostatectomy/adverse effects* ; Prostatectomy/methods ; Prostatectomy/statistics & numerical data ; Prostatic Neoplasms/epidemiology* ; Prostatic Neoplasms/surgery* ; Risk Factors ; Robotics
Keywords
lymphocele ; prostatectomy ; prostatic neoplasms ; robotics
Abstract
OBJECTIVES: To investigate the incidence of lymphocele and determine the risk factors for postoperative lymphocele after extraperitoneal robot-assisted radical prostatectomy by using propensity score-matching. METHODS: A total of 483 patients underwent extraperitoneal robot-assisted radical prostatectomy for prostate cancer between January 2009 and August 2011. Of these, 200 patients underwent pelvic lymph node dissection during robot-assisted radical prostatectomy. All patients underwent magnetic resonance imaging or computed tomography postoperatively to detect lymphocele after robot-assisted radical prostatectomy. Propensity scores for an established control group were calculated for each patient using multivariate logistic regression based on the following covariates: age, body mass index, preoperative prostate-specific antigen level, prostate volume calculated by transrectal ultrasound, biopsy Gleason sum and clinical tumor stage. RESULTS: Lymphocele was identified in 41 patients (20.5%). There were no statistical differences in variables used in propensity score-matching. Operation time, estimated blood loss, catheterization and surgical margin positivity did not show differences between the two groups. Seminal vesicle invasion (P = 0.015) and tumor volume (P = 0.042) between the two groups were significantly different. In the multivariate logistic regression model, extracapsular extension (P = 0.017, odds ratio 4.231), seminal vesicle invasion (P = 0.028, odds ratio 2.643) and the number of positive lymph nodes (P = 0.041, odds ratio 3.532) were independent risk factors for lymphocele development after extraperitoneal robot-assisted radical prostatectomy with pelvic lymph node dissection. CONCLUSIONS: Lymphocele might preferentially develop in cases with seminal vesicle invasion and large tumor volume. Additionally, extracapsular extension, seminal vesicle invasion, and the number of positive lymph nodes are independent risk factors for postoperative lymphocele after extraperitoneal robot-assisted radical prostatectomy.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/iju.12144/abstract
DOI
10.1111/iju.12144
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Diaz, Richilda Red(리칠다)
Yu, Ho Song(유호송)
Lee, Joo Yong(이주용) ORCID logo https://orcid.org/0000-0002-3470-1767
Chung, Jae Seung(정재승)
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Ham, Won Sik(함원식) ORCID logo https://orcid.org/0000-0003-2246-8838
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88634
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