title: [Perioperative management of radical prostatectomy: a nationwide survey in Japan].
abstract: OBJECTIVE
  Recently, various types of radical surgery have been performed in Japan. To elucidate the surgical consequences, morbidity and mortality, and perioperative care, we conducted a nationwide survey.
  
  
  METHODS
  Assisted by the Japanese Society of Endourology, perioperative data from 156 hospitals participating in this survey in 2007 were analyzed. Using a spreadsheet database, data were collected from each institution.
  
  
  RESULTS
  Open radical prostatectomy was performed in 3,138 patients at 143 hospitals, minimum incision endourological radical prostatectomy in 361 at 15 hospitals, laparoscopic radical prostatectomy via transperitoneal approach in 143 at 11 hospitals and laparoscopic radical prostatectomy via extraperitoneal approach in 337 at 13 hospitals. For open and minimum incision endourological radical prostatectomy, the surgical duration was shorter but the bleeding volume was greater than that in laparoscopic radical prostatectomy via both approaches. As a whole, perioperatvie mortality rate was 0.05% and morbidity rate was 23.4%. Rectal injury was similarly infrequent among the four types of surgery. Superficial surgical site infection was most frequent in open radical prostatectomy. Perioperative management significantly varied among the four types of surgery. In laparoscopic radical prostatectomy via extraperitoneal approach, urethral catheter was removed earlier but acute urinary retention frequently occurred.
  
  
  CONCLUSIONS
  In Japan, open radical prostatectomy was the most frequently performed surgery for prostate cancer. Surgical volume per hospital was small, however, mortality was low and morbidity was acceptable. Comparisons of complications and outcomes among the types of currently performed surgery should be useful to promote standardization of the perioperative care.
authors.affiliation: Division of Urology, Department of Surgery and Intensive Care, National Center for Geriatrics and Gerontology.
authors.forename: Kikuo
authors.initials: K
authors.lastname: Okamura
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Tsushima
authors.forename: Mutsushi
authors.initials: M
authors.lastname: Kawakita
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Nojiri
authors.forename: Seiji
authors.initials: S
authors.lastname: Naito
authors.forename: Tadashi
authors.initials: T
authors.lastname: Matsuda
authors.forename: Ryohei
authors.initials: R
authors.lastname: Hattori
authors.forename: Tomonori
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kaiho
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Arai
mesh_terms: D000368:Aged; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D011468:Prostatectomy / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000601:surgery*