Comparison of transfusion requirements between open and robotic-assisted laparoscopic radical prostatectomy.

Abstract:

OBJECTIVE:To determine whether robotic-assisted laparoscopic radical prostatectomy (RALP) is associated with a lower transfusion rate than radical retropubic prostatectomy (RRP). PATIENTS AND METHODS:In this cohort study, we evaluated 1244 consecutive patients who underwent RALP (830) or RRP (414) between June 2003 and July 2006. Demographics, clinical characteristics, pathology, blood loss and transfusion data were collected prospectively. Groups were compared for baseline characteristics, blood loss, change in haematocrit and transfusion using univariate statistics, and an exploratory multivariate model was developed. RESULTS:RALP was associated with lower blood loss (median 100 vs 450 mL, P < 0.001) and a smaller change in haematocrit (median 7% vs 10%, P < 0.001) than RRP. Although both groups had low transfusion rates, the RALP group required fewer transfusions than the RRP group (0.8% vs 3.4%, P= 0.002). On univariate analysis, surgical approach (RRP vs RALP), estimated blood loss ≥500 mL and change in haematocrit ≥10% were the only the significant predictors of transfusion. In the exploratory multivariate model RALP was the only significant predictor of reduced need for transfusion, with an odds ratio of 0.23 (95% confidence interval 0.09-0.58; P= 0.002). CONCLUSIONS:This study shows that RALP is associated not only with less blood loss and a smaller decrease in haematocrit, but also a decreased need for transfusion.

journal_name

BJU Int

journal_title

BJU international

authors

Kordan Y,Barocas DA,Altamar HO,Clark PE,Chang SS,Davis R,Herrell SD,Baumgartner R,Mishra V,Chan RC,Smith JA Jr,Cookson MS

doi

10.1111/j.1464-410X.2010.09233.x

subject

Has Abstract

pub_date

2010-10-01 00:00:00

pages

1036-40

issue

7

eissn

1464-4096

issn

1464-410X

pii

BJU9233

journal_volume

106

pub_type

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