title: Small bowel obstruction and abdominal pain after robotic versus open radical prostatectomy.
abstract: Objective The aim of this study was to examine whether intraperitoneal robot-assisted surgery leads to small bowel obstruction (SBO), possibly caused by the formation of intra-abdominal adhesions. Materials and methods In total, 7256 men treated by intraperitoneal robot-assisted radical prostatectomy (RARP) and 9787 men treated by retropubic radical prostatectomy (RRP) in 2005-2012 were identified in the Prostate Cancer data Base Sweden (PCBaSe). Multivariable Cox proportional hazards models were used to calculate the risk of readmission for SBO, SBO-related surgery and admissions due to abdominal pain up to 5 years postoperatively. Results During the first postoperative year, the risk of readmission for SBO was higher after RARP than after RRP [hazard ratio (HR) 1.92, 95% confidence interval (CI) 1.14-3.25] but after 5 years there was no significant difference (HR 1.28, 95% CI 0.86-1.91), and there was no difference in the risk of SBO surgery during any period. The risk of admission for abdominal pain was significantly increased after RARP during the first year (HR 2.24, 95% CI 1.50-3.33) but not after 5 years (HR 1.23, 95% CI 0.92-1.63). Conclusion Intraperitoneal RARP had an increased risk of SBO and abdominal pain in the short term during the first year, but not in the long term, compared to RRP.
authors.affiliation: a Department of Surgical and Perioperative Sciences, Urology and Andrology , Umeå University , Umeå , Sweden ;
authors.forename: Karl-Johan
authors.initials: KJ
authors.lastname: Lundström
authors.affiliation: b Regional Cancer Centre , Uppsala , Sweden ;
authors.forename: Yasin
authors.initials: Y
authors.lastname: Folkvaljon
authors.affiliation: c Department of Urology and Population Health, and the Laura & Isaac Perlmutter Cancer Center , New York University and Manhattan Veterans Affairs Medical Center , New York , NY , USA ;
authors.forename: Stacy
authors.initials: S
authors.lastname: Loeb
authors.affiliation: d Department of Surgical Sciences , Uppsala University , Uppsala , Sweden.
authors.forename: Anna Bill
authors.initials: AB
authors.lastname: Axelson
authors.affiliation: a Department of Surgical and Perioperative Sciences, Urology and Andrology , Umeå University , Umeå , Sweden ;
authors.forename: Pär
authors.initials: P
authors.lastname: Stattin
authors.affiliation: a Department of Surgical and Perioperative Sciences, Urology and Andrology , Umeå University , Umeå , Sweden ;
authors.forename: Pär
authors.initials: P
authors.lastname: Nordin
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D049671:History, 18th Century; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology; D007415:Intestinal Obstruction / Q000209:etiology*; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D065287:Robotic Surgical Procedures; D000267:Tissue Adhesions / Q000209:etiology
keywords: Adhesions; intestinal obstruction; open prostatectomy; robot-assisted radical prostatectomy; small bowel obstruction