title: Comprehensive standardized report of complications of retropubic and laparoscopic radical prostatectomy.
abstract: BACKGROUND
  The lack of standardized reporting of the complications of radical prostatectomy in the literature has made it difficult to compare incidences across institutions and across different surgical approaches.
  
  
  OBJECTIVE
  To define comprehensively the incidence, severity, and timing of onset of medical and surgical complications of open retropubic prostatectomy (RP) and laparoscopic radical prostatectomy (LP) using a standardized reporting methodology to facilitate comparison.
  
  
  METHODS
  Between January 1999 and June 2007, 4592 consecutive patients underwent RP or LP without prior radiation or hormonal therapy. Median follow-up was 36.9 mo (interquartile range: 20.3-60.6).
  
  
  METHODS
  Open or laparoscopic radical prostatectomy.
  
  
  METHODS
  All medical and surgical complications of radical prostatectomy were captured and graded according to the modified Clavien classification and classified by timing of onset.
  
  
  CONCLUSIONS
  There were 612 medical complications in 467 patients (10.2%) and 1426 surgical complications in 925 patients (20.1%). The overall incidences of early minor and major medical and surgical complications for RP were 8.5% and 1.5% for medical and 11.4% and 4.9% for surgical complications, respectively. The overall incidences of early minor and major medical and surgical complications for LP were 14.2% and 2.3% for medical and 23.1% and 6.6% for surgical complications, respectively. On multivariate analysis, LP approach was associated with a higher incidence of any grade medical and surgical complications but a lower incidence of major surgical complications than RP. Six hundred fifty-two men (14.2%) visited the emergency department, and 240 men (5.2%) required readmission. The main limitation is the retrospective nature.
  
  
  CONCLUSIONS
  With standardized reporting, the incidence of some complications is higher than recognized in the literature. Although most complications are minor in severity, medical and surgical complications are observed in approximately 10% and 20% of patients, respectively. Accurate reporting of complications through a standardized methodology is essential for counseling patients regarding risk of complications, for identifying modifiable risk factors, and for facilitating comparison across institutions and approaches.
authors: Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. rabbanif@mskcc.org
authors: Farhang
authors: F
authors: Rabbani
authors: Luis Herran
authors: LH
authors: Yunis
authors: Rodrigo
authors: R
authors: Pinochet
authors: Lucas
authors: L
authors: Nogueira
authors: Kinjal C
authors: KC
authors: Vora
authors: James A
authors: JA
authors: Eastham
authors: Bertrand
authors: B
authors: Guillonneau
authors: Vincent
authors: V
authors: Laudone
authors: Peter T
authors: PT
authors: Scardino
authors: Karim
authors: K
authors: Touijer
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008297:Male; D008499:Medical Records / Q000592:standards; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors