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5 September 2008
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EERPE feasible, effective in obese patients
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MedWire News: Endoscopic extraperitoneal radical prostatectomy (EERPE) is a feasible and reproducible surgical technique in obese patients with prostate cancer, researchers report.
The findings "are encouraging for the safety and the effectiveness of EERPE in obese patients," Jens-Uwe Stolzenburg (University of Leipzig, Germany) and colleagues note in the British Journal of Urology International.
Previous studies have indicated that obesity might increase the operative duration of laparoscopic RPE, with some suggesting that obesity might be a contraindication for the procedure.
Stolzenburg and team evaluated the impact of obesity on the performance and functional results of EERPE in 500 patients who were categorized into three groups according to the World Health Organization classification of obesity: normal weight (body mass index [BMI] <25.0 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30.0 kg/m2). A total of 26.8% of patients were classed as normal weight, 56.6% overweight, and 16.6% were classed as obese.
The age, prostate size, and preoperative prostate-specific antigen (PSA) level were similar in all three groups, and there was no statistically significance difference in the number of patients in each group who had previous procedures.
The team found that obese patients had a significantly higher American Society of Anesthesiologists score. The mean operative duration for all patients was 149 min, but there was a statistically significant difference in duration among the three groups, with EERPE or nerve-sparing EERPE (nsEERPE) requiring a mean of 20 min more in obese patients than the others.
The researchers also found a trend to worse continence in obese patients 3 months after EERPE, but it was not statistically significant, and was no longer apparent at 6 months.
"Obesity is not a contraindication to EERPE/nsEERPE," the authors write.
They conclude: "Despite significantly longer surgery, the functional outcome of EERPE is not compromised in obese patients, but we suggest that it is performed by an experienced surgical team in such patients."
BJU Int 2008; 102: 718-722
http://www3.interscience.wiley.com/journal/120125749/abstract
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