Jämförelse mellan öppen och robotassisterad kirurgi vid prostatacancer med avseende på vårdskador

Abstract

Abstract in English Comparison between Open and Robot assisted surgery in prostate cancer regarding adverse events Student: David Wallin Supervisor: Professor Eva Haglind Background: Robot-assisted laparoscopic radical prostatectomy (RALP) has become widely used side by side with the golden standard technique Retropubic Radical Prostatectomy (RRP). Still, there are no studies comparing the incidence of adverse events between the two techniques. Objective: To retrospectively study the patients in the LAPPRO-trial regarding adverse events leading to readmission within 3 months after prostatectomy with RALP or RRP, using the Clavien-Dindo system. Methods: Using the National Patient Register, the patient records were collected from the different health care providers. Each readmission was classified according to the Clavien-Dindo system and given one ICD-10 code (which were then sorted into groups). The proportions of readmissions receiving a specific grade were measured as “number of readmissions per 100 treated patients” (ra/100 pat) Results: RALP had a higher proportion of patients in grade 1 (2 ra/100 pat) and grade 2 (4 ra/100 pat) compared to RRP: grade 1 (1 ra/100 pat) and grade 2 (3 ra/100 pat). RRP had a higher proportion of grade 3a readmission (3 ra/100 pat) compared to RALP (1 ra/100 pat). The proportion of grade 3b readmissions was (2 ra/100 pat) for both RALP and RRP. Regarding the types of ICD-10 RALP-patients seemed to have more diseases from the digestive system and more nonspecific abdominal pain. RRP-patients seemed to suffer from more pulmonary embolism, noninfectious diseases in the lymphatic system, diseases in the genitourinary system and urinary retention. Conclusions: There was no difference between the two surgical techniques regarding the total proportion of readmissions but RALP-patients seemed to require less invasive therapy compared to RRP-patients. RALP-patients seemed to have more adverse events from the abdomen and the RRP patients seemed to have more pulmonary embolism and more adverse events from the genitourinary system and the lymphatic system.