Perioperative and short-term outcomes of laparoscopic radical prostatectomy in elderly patients

老年患者腹腔镜根治性前列腺切除术的围手术期和短期结果

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Abstract

OBJECTIVE: To precisely assess whether laparoscopic radical prostatectomy is safe and efficient in elderly individuals suffering from localized prostate cancer in the perioperative and short-term postoperative periods. METHODS: A comprehensive retrospective analysis was undertaken of the clinical records pertaining to patients who underwent laparoscopic radical prostatectomy at our institution, spanning from January 2022 to November 2024. These patients were subsequently categorized into an elderly cohort (≥80 years old, n=54) and a non-elderly cohort (<80 years old, n=67) on the basis of age. Aside from that, the surgical safety and efficacy were compared between these two groups. RESULTS: The patients were stratified into two distinct groups: the elderly cohort and the non-elderly cohort. Notably, no statistically discernible differences emerged between thesese two groups with regard to the duration of the surgical procedure [(136.9 ± 47.8) min vs. (140.5 ± 40.4) min], intraoperative blood loss [(11.9 ± 8.1) g/L vs. (12.4 ± 6.3) g/L], postoperative renal function changes [(5.6 ± 14.9) μmol/L vs. (2.3 ± 9.1) μmol/L], in dwelling catheter time [(10.0 ± 2.8) days vs. (10.4 ± 2.5) days], hospital stay [(14.8 ± 4.5) days vs. (14.5 ± 3.9) days], and hospitalization costs [(25,638.3 ± 5,389.5) yuan vs. (24,589.8 ± 4,162.5) yuan] (all P > 0.05). Nonetheless, the recovery time of intestinal function [1 (1, 2) days vs. 1 (1, 1) days] demonstrated a conspicuous difference (P < 0.05). At 6 weeks postoperatively, the tPSA levels were [(0.019 ± 0.018) ng/mL vs. (0.017 ± 0.017) ng/mL] in the two groups, with no statistically significant difference (P > 0.05).Postoperative intensive care unit transfers (all for 1 day) were 21 and 8 cases in the two groups, separately, while infection-related fever occurred in 13 and 7 cases, severally, both showing statistically significant differences (P < 0.05). No significant disparity in urinary control was detected between these two groups at the 3-month follow-up post-catheter removal (P > 0.05). CONCLUSION: For elderly individuals suffering from localized prostate cancer, laparoscopic radical prostatectomy has demonstrated favorable safety and efficacy in the perioperative and short-term postoperative periods, and is deemed a feasible surgical option for patients with favorable overall physical health.

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