Complications of simple open prostatectomy in geriatric patients
Keywords:
prostate, prostatectomy, complications, risk factors.Abstract
Introduction: Adenoma exeresis is the surgical treatment recommended for patients with prostatic hyperplasia.
Objective: Evaluate the complications of simple open prostatectomy in geriatric patients.
Methods: An observational retrospective longitudinal descriptive study was conducted of 106 geriatric patients undergoing open surgery for benign prostatic hyperplasia at Comandante Manuel Fajardo Clinical Surgical University Hospital in the period 2012-2017. The sample was divided into two groups: retropubic and transvesical surgery. Summary measurements, mean and standard deviation were estimated for quantitative variables and percentages for qualitative variables. The X2 test was used to establish associations, and the non-parametric mean comparison test was applied to independent samples. Multivariate analysis was performed to estimate the risk factors for complications. A p value ˂ 0.05 was considered.
Results: Mean age was 74 years. Of the patients studied, 68.9% had comorbidities, with a predominance of ASA II (58.4%), patients with severe and moderate obstructive symptoms (86.9%), and quality-of-life-related effects (71.7%). 30.1% presented complications, mostly postoperative and grade I, with no differences between retropubic and transvesical surgery. Complications were not associated to age. Identification was made of risk factors for the occurrence of complications.
Conclusions: Postoperative complications prevailed. Renal damage, pharmacological treatment failure, preoperative urinary infection, hospital stay and surgical time were identified as the risk factors causing the complications.
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References
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21. Andersen BM. Prevention of postoperative wound infections. Prevention and control of infections in hospitals. 2018 [acceso 14/01/2020];377-437. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7122543/pdf/978-3-319-99921-0_Chapter_33.pdf
22. Marmiroli R, Antunes AA, Reis ST, Nakano E, Srougi M. Standard surgical treatment for benign prostatic hyperplasia is safe for patients over 75 years: analysis of 100 cases from a high-volume urologic center. Clinics (Sao Paulo). 2012 [acceso 14/01/2020];67(12):1415-8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3521804/pdf/cln-67-12-1415.pdf
23. Van Tuil T, Dhaif AA, Te Riele WW, van Ramshorst B, Santvoort HC. Systematic review and meta-analysis of liver resection for colorectal metastases in elderly patients. Dig Surg. 2019 [acceso 14/01/2020];36:111-23. Disponible en: https://www.karger.com/Article/PDF/487274
24. Lim BG, Lee IO. Anesthetic management of geriatric patients. Korean J Anesthesiol .2020 [acceso 14/03/2020];73(1):8-29. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000283/pdf/kja-19391.pdf
25. Matta R, Dvorani E, Wallis C, Hird A, La Bossiere J, Kulkarni G, et al. Complications after surgery for benign prostatic enlargement: a population-based cohort study in Ontario, Canada. BMJ Open. 2019 [acceso 14/01/2020];9(12):e032170. Disponible en: https://bmjopen.bmj.com/content/bmjopen/9/12/e032170.full.pdf
2. Rensing AJ, Kuxhausen A, Vetter J, Strope SA. Differences in the treatment of benign prostatic hyperplasia: comparing the Primary Care Physician and the Urologist. Urol Pract. 2018 [acceso 14/01/2020];4(3):193-9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5451141/pdf/nihms823221.pdf
3. Wallace B, Breau RH, Cnossen S, Knee C, Mcisaac D, Mallick R, et al. Age-stratified perioperative mortality after urological surgeries. Can Urol Assoc J. 2018 [acceso 14/01/2020];12(8):256-9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6114166/pdf
4. Bai F, Feng S, Xu C, Xu Z, Chen J, Zheng Y. Transurethral resection versus holmium laser enucleation of the prostate: A prospective randomized trial comparing perioperative thrombin generation and fibrinolysis. Medicine (Baltimore). 2019 [acceso 14/01/2020];98(15):e15223. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6485898/pdf/medi-98-e15223.pdf
5. Cho JM, Moon KT, Yoo TK. Robotic simple prostatectomy: Why and how? Int Neurourol J. 2020 [acceso 03/04/2020];24(1):12-20. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136446/pdf/inj-2040018-009.pdf
6. McKibben MJ, Smith AB. Evaluation and management of the geriatric urologic oncology patient. Curr Geriatr Rep .2015 [acceso 07/02/2021];4(1):7-15. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321682/pdf/nihms633655.pdf
7. Lokeshwar SD, Harper BT, Webb E, Jordan A, Dykes TA, Neal DE Jr. Epidemiology and treatment modalities for the management of benign prostatic hyperplasia. Transl Androl Urol .2019 [acceso 07/02/2021];8(5):529-39. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842780/pdf/tau-08-05-529.pdf
8. Zeng QS, Zhao YB, Wang BQ, Ying M, Hu WL. Minimally invasive simple prostatectomy for a case of giant benign prostatic hyperplasia. Asian J Androl. 2017 [acceso 12/03/2021];19(6):717-8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676434/pdf/AJA-19-717.pdf
9. Picado SE. Generalidades sobre infecciones urinarias en el adulto mayor. Rev Med Cost Cen. 2014 [acceso 14/01/2020];71(611):489-92. Disponible en: https://www.medigraphic.com/pdfs/revmedcoscen/rmc-2014/rmc143u.pdf
10. Albizu-Campos Espiñeira JC. La esperanza de vida en Cuba hoy. Rev Nov Pob. 2018 [acceso 07/02/2019];14(28). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1817-40782018000200271
11. Nadu A, Mabjeesh NJ, Ben-Chaim J, Kaver I, Matzkin H, Greenstein A. Are indications for prostatectomy in octogenarians the same as for younger men? Int Urol Nephr .2004 [acceso 14/01/2020];36:47-50. Disponible en: https://sci-hub.se/10.1023/b:urol.0000032683.36827.63
12. Kazem Aghamir SM, Khatami F, Reza Rahimi M, Guitynavard F. Giant benign prostatic hyperplasia: A case report. Urol Case Repot. 2020 [acceso 15/01/2020];18. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6833462/pdf/main.pdf
13. Türk H, Ün S, Arslan E. A new surgical technique: transvesical resection of prostate-case series. Int Braz J Urol. 2018 [acceso 30/01/2020];44(5):1023. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6237541/pdf/1677-6119-ibju-44-05-1023.pdf
14. Chung ASJ, Woo HH. Update on minimally invasive surgery and benign prostatic hyperplasia. Asian J Uro .2018 [acceso 14/01/2020];5(1):22-27. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5780286/pdf/main.pdf
15. Gravas S, Cornu JN, Drake MJ, Gacci M, Gratzke C, Herrmann TRW, et al. Management of non-neurogenic male lower urinary tract symptoms (LUTS), benign prostatic obstruction (BPO). Europ Assoc Urol. 2018 [acceso 14/01/2020]. Disponible en: https://uroweb.org/wp-content/uploads/EAU-Guidelines-on-the-Management-of-Non-neurogenic-Male-LUTS-2018-large-text.pdf
16. Nickel JC, Aaron L, Barkin J, Elterman D, Nachabé M, Zorn KC. Canadian Urological Association guideline on male lower urinary tract symptoms/benign prostatic hyperplasia (MLUTS/BPH): 2018 update. Can Urol Assoc J .2018 [acceso 04/01/2020];12(10):303-12. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6192748/pdf/cuaj-10-303.pdf
17. Hassanpour A, Hosseini MM, Yousefi A, Inaloo R. Cystostomy-free open suprapubic transvesical prostatectomy: Is it a safe method? Urol Ann .2016 [acceso: 30/03/2020];8(2):213-7. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839242/
18. Liaqat A, Nasir O, Manzoor A. Transvesical Prostatectomy in elderly patients: an experience at Saidu Teaching Hospital Swat. Ann. Pak. Inst. Med. Sci .2008 [acceso 14/01/2020];4(3):148-51. Disponible en: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.679.5044&rep=rep1&type=pdf
19. Carneiro A, Sakuramoto P, Wroclawski ML, Forseto PH, Den Julio A, Bautzer CR. Open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident's learning curve: a randomized controlled trial. Int Braz J Urol .2016 [acceso 14/01/2020];4 2(2):284-92. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871389/pdf/1677-5538-ibju-42-02-0284.pdf
20. Brodak M, Tomasek J, Pacovsky J, Holub L, Husek P. Urological surgery in elderly patients: results and complications. Clin Interv Aging .2015 [acceso 19/01/2020];10:379-84. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321414/pdf/cia-10-379.pdf
21. Andersen BM. Prevention of postoperative wound infections. Prevention and control of infections in hospitals. 2018 [acceso 14/01/2020];377-437. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7122543/pdf/978-3-319-99921-0_Chapter_33.pdf
22. Marmiroli R, Antunes AA, Reis ST, Nakano E, Srougi M. Standard surgical treatment for benign prostatic hyperplasia is safe for patients over 75 years: analysis of 100 cases from a high-volume urologic center. Clinics (Sao Paulo). 2012 [acceso 14/01/2020];67(12):1415-8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3521804/pdf/cln-67-12-1415.pdf
23. Van Tuil T, Dhaif AA, Te Riele WW, van Ramshorst B, Santvoort HC. Systematic review and meta-analysis of liver resection for colorectal metastases in elderly patients. Dig Surg. 2019 [acceso 14/01/2020];36:111-23. Disponible en: https://www.karger.com/Article/PDF/487274
24. Lim BG, Lee IO. Anesthetic management of geriatric patients. Korean J Anesthesiol .2020 [acceso 14/03/2020];73(1):8-29. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000283/pdf/kja-19391.pdf
25. Matta R, Dvorani E, Wallis C, Hird A, La Bossiere J, Kulkarni G, et al. Complications after surgery for benign prostatic enlargement: a population-based cohort study in Ontario, Canada. BMJ Open. 2019 [acceso 14/01/2020];9(12):e032170. Disponible en: https://bmjopen.bmj.com/content/bmjopen/9/12/e032170.full.pdf
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2021-09-02
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Cutiño Pérez A, Quintana Rodríguez M, Ares Valdez Y, Olivé Gómez JE. Complications of simple open prostatectomy in geriatric patients. Rev. Cubana Urol. [Internet]. 2021 Sep. 2 [cited 2024 Dec. 22];10(3). Available from: https://revurologia.sld.cu/index.php/rcu/article/view/729
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