title: Robotic-assisted radical prostatectomy is less stressful than the open approach: results of a contemporary prospective study evaluating pathophysiology of cortisol stress-related kinetics in prostate cancer surgery.
abstract: The objective of this study was to investigate the effects of prostate cancer (PCA) surgery on the stress system and to identify potential independent factors associating with stress recovery. The design of the study was prospective and PCA surgery included robot-assisted radical prostatectomy (RARP) or retro pubic radical prostatectomy. Between February and December 2013, 151 consecutive patients were evaluated. The effects of PCA surgery on the stress system were measured by cortisol serum levels before and after surgery on post-operative day (POD) 0, 1, 3, 5 and 45. Statistical methods were applied. RARP was performed in 71% of cases. PCA surgery triggered the stress system which immediately (POD 0) responded by cortisol overproduction which induced the negative feedback mechanism that started on POD 1, continued on POD.
authors.affiliation: Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy. drporcaro@yahoo.com.|Divisione Clinicizzata Di Urologia, Dipartimento ad Attività Integrata di Chirurgia e Oncologia, Pancreas Center, Azienda Ospedaliera Universitaria Integrata Verona, Policlinico GB Rossi-P.le LA Scuro, 10, 37134, Verona, Italy. drporcaro@yahoo.com.
authors.forename: Antonio B
authors.initials: AB
authors.lastname: Porcaro
authors.affiliation: Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Molinari
authors.affiliation: Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Terrin
authors.affiliation: Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: De Luyk
authors.affiliation: Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Baldassarre
authors.affiliation: Department of Pathology, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Brunelli
authors.affiliation: Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cavalleri
authors.affiliation: Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Cerruto
authors.affiliation: Department of Pathology, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Gelati
authors.affiliation: Department of Laboratory Medicine, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Salvagno
authors.affiliation: Department of Laboratory Medicine, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Gian Cesare
authors.initials: GC
authors.lastname: Guidi
authors.affiliation: Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Artibani
mesh_terms: D000368:Aged; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011467:Prostate / Q000601:surgery*; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000379:methods*; D013312:Stress, Physiological
chemical_list: D006854:Hydrocortisone
keywords: Cortisol hormone; Prostate cancer; Retropubic radical prostatectomy; Robot-assisted radical prostatectomy; Stress system