title: Surgical complications associated with robotic urologic procedures in elderly patients.
abstract: BACKGROUND
  Urologic malignancies are often diagnosed at an older age, and are increasingly managed utilizing robotic-assisted surgical techniques. As such, we assessed and compared peri-postoperative complication rates following robotic urologic surgery in elderly and younger patients.
  
  
  METHODS
  A retrospective analysis of IRB-approved databases and electronic medical records identified patients who underwent robotic-assisted urologic surgery between December 2003-September 2013. Patients were grouped according to surgical procedure (partial nephrectomy, radical cystectomy, radical prostatectomy) and age at surgery (≤ 74 or ≥ 75 years old). Associations between age, comorbidities, Charlson comorbidity index (CCI), and patient outcomes were evaluated within each surgery type.
  
  
  RESULTS
  97.5% and 2.5% of patients were ≤ 74 or ≥ 75 years old, respectively. Cystectomies, partial nephrectomies and prostatectomies accounted for 3.5%, 9.5% and 87.1% of surgeries, respectively. Within cystectomy, nephrectomy and prostatectomy groups, 24.4%, 12.5% and 0.6% patients were ≥ 75 years old. Within each surgical type, elderly patients had significantly elevated CCI scores. Length of stay was significantly prolonged in elderly patients undergoing partial nephrectomy or prostatectomy. In elderly cystectomy, partial nephrectomy and prostatectomy patients, 36.7%, 14.3% and 5.9% suffered ≥ 1 Clavien grade 3-5 complication, respectively. Major complications were not significantly different between age groups. A qualitatively similar pattern was observed regarding Clavien grade 1-2 complications.
  
  
  CONCLUSIONS
  The risks of robotic-assisted urologic surgery in elderly patients are not significantly elevated compared to younger patients.
authors.affiliation: Hartford Healthcare Medical Group, Hartford, Connecticut, USA.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cusano
authors.forename: Peter
authors.initials: P
authors.lastname: Haddock
authors.forename: Ilene
authors.initials: I
authors.lastname: Staff
authors.forename: Max
authors.initials: M
authors.lastname: Jackson
authors.forename: Fernando
authors.initials: F
authors.lastname: Abarzua-Cabezas
authors.forename: Ryan
authors.initials: R
authors.lastname: Dorin
authors.forename: Anoop
authors.initials: A
authors.lastname: Meraney
authors.forename: Joseph
authors.initials: J
authors.lastname: Wagner
authors.forename: Steven
authors.initials: S
authors.lastname: Shichman
authors.forename: Stuart
authors.initials: S
authors.lastname: Kesler
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000009:adverse effects; D005260:Female; D006304:Health Status; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology; D011468:Prostatectomy / Q000009:adverse effects; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects*; D013520:Urologic Surgical Procedures / Q000009:adverse effects*