Incidence and Risk Factors of Pulmonary Complications after Robot-Assisted Laparoscopic Prostatectomy: A Retrospective Observational Analysis of 2208 Patients at a Large Single Center

被引:19
作者
Yu, Jihion [1 ]
Park, Jun-Young [1 ]
Kim, Doo-Hwan [1 ]
Kim, Sungwon [1 ]
Hwang, Jai-Hyun [1 ]
Seo, Hyungseok [2 ]
Kim, Young-Kug [1 ]
机构
[1] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Anesthesiol & Pain Med, Seoul 05505, South Korea
[2] Kyung Hee Univ, Coll Med, Kyung Hee Univ Hosp Gangdong, Dept Anesthesiol & Pain Med, Seoul 05278, South Korea
关键词
robot-assisted laparoscopic prostatectomy; incidence; risk factors; postoperative pulmonary complications; POSTOPERATIVE COMPLICATIONS; RADICAL PROSTATECTOMY; PERIOPERATIVE OUTCOMES; FUNCTIONAL OUTCOMES; SURGERY; VENTILATION; PREDICTORS; PRESSURE; FRAILTY; CANCER;
D O I
10.3390/jcm8101509
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Robot-assisted laparoscopic prostatectomy (RALP) is a minimally invasive technique for the treatment of prostate cancer. RALP requires the patient to be placed in the steep Trendelenburg position, along with pneumoperitoneum, which may increase the risk of postoperative pulmonary complications (PPCs). This large single-center retrospective study evaluated the incidence and risk factors of PPCs in 2208 patients who underwent RALP between 2014 and 2017. Patients were divided into those with (PPC group) and without (non-PPC group) PPCs. Postoperative outcomes were evaluated, and univariate and multivariate logistic regression analyses were performed to assess risk factors of PPCs. PPCs occurred in 682 patients (30.9%). Risk factors of PPCs included age (odds ratio [OR], 1.023; p = 0.001), body mass index (OR, 1.061; p = 0.001), hypoalbuminemia (OR, 1.653; p = 0.008), and positive end-expiratory pressure (PEEP) application (OR, 0.283; p < 0.001). The incidence of postoperative complications, rate of intensive care unit (ICU) admission, and duration of ICU stay were significantly greater in the PPC group than in the non-PPC group. In conclusion, the incidence of PPCs in patients who underwent RALP under pneumoperitoneum in the steep Trendelenburg position was 30.9%. Factors associated with PPCs included older age, higher body mass index, hypoalbuminemia, and lack of PEEP.
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页数:10
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