title: Are Preexisting Retinal and Central Nervous System-Related Comorbidities Risk Factors for Complications Following Robotic-Assisted Laparoscopic Prostatectomy?
abstract: OBJECTIVE
  To assess whether retinal and central nervous system (CNS) comorbidities are risk factors for complications following robotic assisted laparoscopic prostatectomy (RALP).
  
  
  METHODS
  A retrospective review of our RALP database identified 1868 patients who underwent RALP by a single surgeon between December 10, 2003-March 14, 2014. We hypothesized that patients with preexisting retinal or CNS comorbidities were at a greater risk of suffering retinal and CNS complications following RALP. Perioperative complications and risk of recurrence were graded using the Clavien and D'Amico systems, respectively.
  
  
  RESULTS
  40 (2.1%) patients had retinal or CNS-related comorbidities, of which 15 had a history of retinal surgery and 24 had a history of cerebrovascular accident, aneurysm and/or neurosurgery. One additional patient had a history of both retinal and CNS events. Patients with retinal or CNS comorbidities were significantly older, had elevated PSA levels and CCI (Charlson Comorbidity Index) scores than the control group. Blood loss, length of stay, surgical duration, BMI, diagnostic Gleason score and T-stage were not statistically different between groups. No retinal or CNS complications occurred in either group. The distribution of patients between D'Amico risk categories was not statistically different between the groups. There was also no difference in the incidence of total complications between the groups.
  
  
  CONCLUSIONS
  RALP-associated retinal and CNS complications are rare. While our RALP database is large, the cohort of patients with retinal or CNS-related comorbidities was relatively small. Our dataset suggests retinal and CNS pathology presents no greater risk of suffering from perioperative complications following RALP.
authors.affiliation: Department of Urology, University of Connecticut, Farmington, USA and Research Group, Hartford Hospital, Hartford, USA.
authors.forename: David
authors.initials: D
authors.lastname: Chalmers
authors.affiliation: Urology Division, Hartford Healthcare Medical group, Hartford, USA.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cusano
authors.affiliation: Urology Division, Hartford Healthcare Medical group, Hartford, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Haddock
authors.affiliation: Urology Division, Hartford Healthcare Medical group, Hartford, USA.
authors.forename: Ilene
authors.initials: I
authors.lastname: Staff
authors.affiliation: Urology Division, Hartford Healthcare Medical group, Hartford, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Wagner
mesh_terms: D000368:Aged; D002493:Central Nervous System Diseases / Q000453:epidemiology / Q000209:etiology; D015897:Comorbidity; D018475:Head-Down Tilt / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D018917:Optic Neuropathy, Ischemic / Q000453:epidemiology / Q000209:etiology; D059035:Perioperative Period; D011183:Postoperative Complications / Q000209:etiology*; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D012164:Retinal Diseases / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000009:adverse effects*; D018709:Statistics, Nonparametric; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*