title: Open Versus Robotic Radical Prostatectomy in Obese Men.
abstract: OBJECTIVE
  Robotic-assisted radical prostatectomy (RARP) has been shown to reduce blood loss, peri-operative complications and length of stay when compared to open radical prostatectomy (ORP). We sought to determine whether the reported benefits of RARP over ORP translate to obese patients.
  
  
  METHODS
  We utilized the 2009-2010 Nationwide Inpatient Sample to identify all obese men with prostate cancer who underwent ORP and RARP. Our primary outcome was the presence of a peri-operative adverse event (i.e. blood transfusion, complication, prolonged length of stay). We fit multivariable logistic regression models to examine whether RARP in obese patients was independently associated with decreased odds of all three outcomes.
  
  
  RESULTS
  We identified 9,108 obese patients who underwent radical prostatectomy. On multivariable analysis, the use of RARP in the obese population was not independently associated with decreased odds of developing a peri-operative complication (OR = 0.81, CI: 0.58-1.13, p = 0.209). RARP was, however, associated with decreased odds of blood transfusion (OR = 0.17, CI: 0.10-0.30, p < 0.001) and prolonged length of stay (OR = 0.28, CI: 0.20-0.40, p < 0.001).
  
  
  CONCLUSIONS
  Our findings suggest that in obese patients, the use of RARP may reduce length of stay and blood transfusions compared to ORP. Both approaches, however, are associated with similar odds of developing a complication.
authors.affiliation: Loyola University Medical Center, Maywood, IL., USA.
authors.forename: Chandy
authors.initials: C
authors.lastname: Ellimoottil
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Department of Urology, Ruhr University Bochum, Marienhospital, Herne, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Roghmann
authors.affiliation: Loyola University Medical Center, Maywood, IL., USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Blackwell
authors.affiliation: Loyola University Medical Center, Maywood, IL., USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Kadlec
authors.affiliation: Loyola University Medical Center, Maywood, IL., USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Greco
authors.affiliation: Loyola University Medical Center, Maywood, IL., USA.
authors.forename: Marcus L
authors.initials: ML
authors.lastname: Quek
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada.
authors.forename: Maxine
authors.initials: M
authors.lastname: Sun
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada; Division of Urologic Surgery and Center for Surgery and Public Health, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA., USA.
authors.forename: Quoc-Dien
authors.initials: QD
authors.lastname: Trinh
authors.affiliation: Loyola University Medical Center, Maywood, IL., USA.
authors.forename: Gopal
authors.initials: G
authors.lastname: Gupta
keywords: Obesity; Prostate cancer; Prostatectomy; Robotic surgery