title: Complications associated with extraperitoneal robot-assisted radical prostatectomy using the standardized Martin classification.
abstract: OBJECTIVE
  To report and identify the predictors of early and long-term complications in a large series of extraperitoneal robot-assisted radical prostatectomy using the standardized Martin criteria.
  
  
  METHODS
  A total of 1503 patients underwent extraperitoneal robot-assisted radical prostatectomy for the treatment of clinically localized prostate cancer from July 2003 to August 2010 at a tertiary referral center. The median follow-up was 28.9 months. Fisher's exact test was used to examine the association of multiple variables in a bivariate analysis with the incidence and types of complications. Independent predictors were also examined in a multivariate analysis using logistic regression models.
  
  
  RESULTS
  A total of 151 complications were recorded in 127 of 1503 patients (8.45%). Approximately one third (30.5%) were classified as major complications requiring intervention (Clavien grade III and IV). The most commonly encountered complications were lymphocele (1.46%), bladder neck contracture (1.33%), and anastomotic leak (1.20%). The operative time was a significant predictor of all complications and of major complications on multivariate analysis. Surgeon experience was also predictive of complications on multivariate analysis.
  
  
  CONCLUSIONS
  Extraperitoneal robot-assisted radical prostatectomy remains an underused alternative approach for the treatment of localized prostate cancer. Its safety profile is equivalent to that of other approaches in experienced hands.
authors: Department of Urology, University of Rochester Medical Center, Rochester, NY 14642, USA. ahmed_ghazi@urmc.rochester.edu
authors: Ahmed
authors: A
authors: Ghazi
authors: Emelian
authors: E
authors: Scosyrev
authors: Hitendra
authors: H
authors: Patel
authors: Edward M
authors: EM
authors: Messing
authors: Jean V
authors: JV
authors: Joseph
mesh_terms: D000368:Aged; D057868:Anastomotic Leak / Q000145:classification / Q000209:etiology; D002983:Clinical Competence; D006801:Humans; D007431:Intraoperative Complications / Q000145:classification* / Q000209:etiology; D016015:Logistic Models; D008197:Lymph Node Excision / Q000009:adverse effects; D008210:Lymphocele / Q000145:classification / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D061646:Operative Time; D011183:Postoperative Complications / Q000145:classification* / Q000209:etiology; D011468:Prostatectomy / Q000009:adverse effects*; D012371:Robotics; D001745:Urinary Bladder Diseases / Q000145:classification / Q000209:etiology