Background: Perioperative bleeding is a potential complication of robot-assisted laparoscopic radical prostatectomy (RALP) that may worsen outcomes. The role of local hemostatic materials in RALP has not been adequately assessed. We evaluated the hemostatic impact of FloSeal (Baxter International Inc., Fremont, Calif., USA) in RALP.
Methods: A retrospective analysis was performed of 392 consecutive patients with prostate cancer who underwent RALP at our institution between February 2008 and July 2014. The patients were divided into 2 consecutive homogenous groups based on the use of FloSeal. Group A included 200 patients who underwent RALP between February 2008 and May 2011, with hemostasis performed using only traditional techniques. Group B included the remaining 192 patients, who underwent RALP between June 2011 and July 2014 and received FloSeal 5 ml after traditional hemostatic methods. We compared the blood transfusion rate, the differences between immediate postoperative hemoglobin (Hb) and mean postoperative day 1 (POD1) Hb levels, difference between POD1 and least Hb levels and difference between immediate postoperative Hb and least Hb levels.
Results: The intraoperative use of FloSeal significantly decreased the blood transfusions rate, from 8.5 to 2.1% (p = 0.004). FloSeal was also associated with significant improvements in the difference between the immediate postoperative Hb and POD1 Hb levels (p = 0.03), mean POD1 Hb and least Hb (p = 0.01) and mean immediate postoperative Hb and least Hb levels (p = 0.034).
Conclusions: In this study, the use of FloSeal improves hemostatic outcomes in patients undergoing RALP compared with traditional hemostatic techniques, without increase of cost.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1159/000444304 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Extraperitoneal Robot-Assisted Laparoscopic Radical Prostatectomy in Continuous Spinal Anesthesia: A New Approach to an Established Technique.
Medicina (Kaunas)
December 2024
Department of Urology, C.Ur.E.-Centro Urologico Europeo, Hesperia Hospital, 41125 Modena, Italy.
To prove the feasibility of continuous spinal extraperitoneal robot-assisted laparoscopic radical prostatectomy (cseRALP) in order to expand the pool of eligible patients. : According to IDEAL guidelines, a consecutive cohort of patients who underwent cseRALP was enrolled. Pre-, intra-, and post-operative data were collected, with particular focus on safety and oncological outcomes.
View Article and Find Full Text PDFLateral decubitus: its influence on hemodynamic and respiratory function during retroperitoneal robotic assisted laparoscopic pyeloplasty (R-RALP) in children.
J Robot Surg
January 2025
Department of Pediatric Anesthesia and Intensive Care, Necker-Enfants Malades University Hospital, AP-HP Centre, Université Paris Cité, 149, Rue de Sèvres 75015, Paris, France.
Retroperitoneal robotic-assisted laparoscopic pyeloplasty (R-RALP) is the commonest urologic procedure performed in children, entailing retroperitoneal CO2 insufflation and lateral decubitus, whose effects on cardiopulmonary variables are poorly known. We, therefore, studied hemodynamic and respiratory changes due to CO2 insufflation and lateral decubitus in children undergoing R-RALP and their effects on regional tissue oxygenation. Between 1/2021 and 7/2024, children affected by ureteropelvic joint obstruction (UPJO) underwent a pyeloplasty by R-RALP at Necker Enfants Malades Hospital (Paris, France), using a standardized surgical technique and a lung-protecting anesthetic protocol aimed to prevent hypercarbia.
View Article and Find Full Text PDFRisk of Incontinence after Radical Prostatectomy According to Procedural Types: Retrospective Cohort Study Using National Health Insurance Data.
World J Mens Health
December 2024
Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
Purpose: Although surgical procedures including robotic surgery in radical prostatectomy have evolved, urinary incontinence after surgery are still not resolved. This study was to evaluate the risk of clinically significant incontinence after radical prostatectomy according to various procedural types.
Materials And Methods: The retrospective cohort study included prostate cancer (n=14,484) in South Korea between 2002 and 2017 as shown in the National Health Insurance Data.
Stimulated Raman Histology and Artificial Intelligence Provide Near Real-Time Interpretation of Radical Prostatectomy Surgical Margins.
J Urol
December 2024
Dept. of Urology, NYU Langone Health, New York, New York, United States.
Introduction: Balancing surgical margins and functional outcomes is crucial during radical prostatectomy for prostate cancer. Stimulated Raman Histology (SRH) is a novel, real-time imaging technique that provides histologic images of fresh, unprocessed, and unstained tissue within minutes, which can be interpreted by either humans or artificial intelligence.
Methods: Twenty-two participants underwent robotic-assisted laparoscopic radical prostatectomy (RALP) with intraoperative SRH surgical bed assessment.
Robotic radical prostatectomy (RALP) with pre-existing inflatable penile prosthesis (IPP): technical innovations to improve safety and outcomes.
J Robot Surg
November 2024
Larkin Palm Springs Hospital, Miami, FL, 33012, USA.
Article Synopsis
- - Robotic-assisted laparoscopic radical prostatectomy (RALP) is the standard treatment for prostate cancer, with specific techniques developed for men who already have an inflatable penile prosthesis (IPP).
- - Two surgical techniques, the No Touch Technique and Safe Mobilization Technique, aim to preserve the pelvic reservoir during RALP, with no significant differences in surgical outcomes between men with IPP and those without.
- - Analysis of 155 RALP cases with IPPs showed successful postoperative device functionality, no significant complications, and no negative impact on urinary continence or cancer recurrence rates compared to men without IPPs.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!