Periprostatic fat area is an independent factor that prolonged operative time in laparoscopic radical prostatectomy

Gou Kaneko, Akira Miyajima, Kazuyuki Yuge, Masanori Hasegawa, Toshikazu Takeda, Masahiro Jinzaki, Eiji Kikuchi, Ken Nakagawa, Mototsugu Oya

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective To evaluate the effect of visceral obesity on surgical outcomes in laparoscopic radical prostatectomy (LRP). Methods Visceral fat area (VFA) and periprostatic fat area (PPFA) were used as index of visceral obesity. In addition to VFA and PPFA, age, body mass index (BMI), prostate weight, cross-section area of Retzius space, history of previous abdominal surgery, repeated transrectal needle biopsy, and neoadjuvant hormone therapy were recorded. LRP was separated into 7 steps (1: port insertion and lymph node dissection, 2: endopelvic fascia incision, 3: dorsal vein complex ligation, 4: prostate dissection from bladder neck, 5: dissection of seminal vesicle and vas deferens, 6: prostate dissection from rectum, and 7: vesicourethral anastomosis). Potential factors that prolonged total operative time (OT), pneumoperitoneum time, and duration of each step were assessed by multivariate logistic regression analysis. The association between visceral obesity and other surgical outcomes was also evaluated. Results One hundred sixteen LRPs were performed by a single experienced surgeon. High PPFA and prostate weight were independent factors that prolonged total OT and pneumoperitoneum time. High BMI was not a factor. PPFA affected steps 1, 4, 5, and 6, and prostate weight affected prolonged steps 5 and 6. Estimated blood loss, duration of urethral catheterization, postoperative hospital stay, perioperative complications, and margin status were not affected by visceral obesity. Conclusion PPFA was more useful to accurately predict prolonged OT than VFA or BMI. Safety and margin status were not compromised even in high PPFA group when operations were performed by an experienced surgeon.

Original languageEnglish
Pages (from-to)1304-1309
Number of pages6
JournalUrology
Volume82
Issue number6
DOIs
Publication statusPublished - 2013 Dec

Fingerprint

Operative Time
Prostatectomy
Abdominal Obesity
Fats
Prostate
Intra-Abdominal Fat
Pneumoperitoneum
Body Mass Index
Weights and Measures
Dissection
Urinary Catheterization
Neoadjuvant Therapy
Neck Dissection
Vas Deferens
Seminal Vesicles
Fascia
Needle Biopsy
Lymph Node Excision
Rectum
Ligation

ASJC Scopus subject areas

  • Urology

Cite this

Periprostatic fat area is an independent factor that prolonged operative time in laparoscopic radical prostatectomy. / Kaneko, Gou; Miyajima, Akira; Yuge, Kazuyuki; Hasegawa, Masanori; Takeda, Toshikazu; Jinzaki, Masahiro; Kikuchi, Eiji; Nakagawa, Ken; Oya, Mototsugu.

In: Urology, Vol. 82, No. 6, 12.2013, p. 1304-1309.

Research output: Contribution to journalArticle

Kaneko, Gou ; Miyajima, Akira ; Yuge, Kazuyuki ; Hasegawa, Masanori ; Takeda, Toshikazu ; Jinzaki, Masahiro ; Kikuchi, Eiji ; Nakagawa, Ken ; Oya, Mototsugu. / Periprostatic fat area is an independent factor that prolonged operative time in laparoscopic radical prostatectomy. In: Urology. 2013 ; Vol. 82, No. 6. pp. 1304-1309.
@article{45ffb2ab582e4be587e330e3e21589a5,
title = "Periprostatic fat area is an independent factor that prolonged operative time in laparoscopic radical prostatectomy",
abstract = "Objective To evaluate the effect of visceral obesity on surgical outcomes in laparoscopic radical prostatectomy (LRP). Methods Visceral fat area (VFA) and periprostatic fat area (PPFA) were used as index of visceral obesity. In addition to VFA and PPFA, age, body mass index (BMI), prostate weight, cross-section area of Retzius space, history of previous abdominal surgery, repeated transrectal needle biopsy, and neoadjuvant hormone therapy were recorded. LRP was separated into 7 steps (1: port insertion and lymph node dissection, 2: endopelvic fascia incision, 3: dorsal vein complex ligation, 4: prostate dissection from bladder neck, 5: dissection of seminal vesicle and vas deferens, 6: prostate dissection from rectum, and 7: vesicourethral anastomosis). Potential factors that prolonged total operative time (OT), pneumoperitoneum time, and duration of each step were assessed by multivariate logistic regression analysis. The association between visceral obesity and other surgical outcomes was also evaluated. Results One hundred sixteen LRPs were performed by a single experienced surgeon. High PPFA and prostate weight were independent factors that prolonged total OT and pneumoperitoneum time. High BMI was not a factor. PPFA affected steps 1, 4, 5, and 6, and prostate weight affected prolonged steps 5 and 6. Estimated blood loss, duration of urethral catheterization, postoperative hospital stay, perioperative complications, and margin status were not affected by visceral obesity. Conclusion PPFA was more useful to accurately predict prolonged OT than VFA or BMI. Safety and margin status were not compromised even in high PPFA group when operations were performed by an experienced surgeon.",
author = "Gou Kaneko and Akira Miyajima and Kazuyuki Yuge and Masanori Hasegawa and Toshikazu Takeda and Masahiro Jinzaki and Eiji Kikuchi and Ken Nakagawa and Mototsugu Oya",
year = "2013",
month = "12",
doi = "10.1016/j.urology.2013.04.077",
language = "English",
volume = "82",
pages = "1304--1309",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Periprostatic fat area is an independent factor that prolonged operative time in laparoscopic radical prostatectomy

AU - Kaneko, Gou

AU - Miyajima, Akira

AU - Yuge, Kazuyuki

AU - Hasegawa, Masanori

AU - Takeda, Toshikazu

AU - Jinzaki, Masahiro

AU - Kikuchi, Eiji

AU - Nakagawa, Ken

AU - Oya, Mototsugu

PY - 2013/12

Y1 - 2013/12

N2 - Objective To evaluate the effect of visceral obesity on surgical outcomes in laparoscopic radical prostatectomy (LRP). Methods Visceral fat area (VFA) and periprostatic fat area (PPFA) were used as index of visceral obesity. In addition to VFA and PPFA, age, body mass index (BMI), prostate weight, cross-section area of Retzius space, history of previous abdominal surgery, repeated transrectal needle biopsy, and neoadjuvant hormone therapy were recorded. LRP was separated into 7 steps (1: port insertion and lymph node dissection, 2: endopelvic fascia incision, 3: dorsal vein complex ligation, 4: prostate dissection from bladder neck, 5: dissection of seminal vesicle and vas deferens, 6: prostate dissection from rectum, and 7: vesicourethral anastomosis). Potential factors that prolonged total operative time (OT), pneumoperitoneum time, and duration of each step were assessed by multivariate logistic regression analysis. The association between visceral obesity and other surgical outcomes was also evaluated. Results One hundred sixteen LRPs were performed by a single experienced surgeon. High PPFA and prostate weight were independent factors that prolonged total OT and pneumoperitoneum time. High BMI was not a factor. PPFA affected steps 1, 4, 5, and 6, and prostate weight affected prolonged steps 5 and 6. Estimated blood loss, duration of urethral catheterization, postoperative hospital stay, perioperative complications, and margin status were not affected by visceral obesity. Conclusion PPFA was more useful to accurately predict prolonged OT than VFA or BMI. Safety and margin status were not compromised even in high PPFA group when operations were performed by an experienced surgeon.

AB - Objective To evaluate the effect of visceral obesity on surgical outcomes in laparoscopic radical prostatectomy (LRP). Methods Visceral fat area (VFA) and periprostatic fat area (PPFA) were used as index of visceral obesity. In addition to VFA and PPFA, age, body mass index (BMI), prostate weight, cross-section area of Retzius space, history of previous abdominal surgery, repeated transrectal needle biopsy, and neoadjuvant hormone therapy were recorded. LRP was separated into 7 steps (1: port insertion and lymph node dissection, 2: endopelvic fascia incision, 3: dorsal vein complex ligation, 4: prostate dissection from bladder neck, 5: dissection of seminal vesicle and vas deferens, 6: prostate dissection from rectum, and 7: vesicourethral anastomosis). Potential factors that prolonged total operative time (OT), pneumoperitoneum time, and duration of each step were assessed by multivariate logistic regression analysis. The association between visceral obesity and other surgical outcomes was also evaluated. Results One hundred sixteen LRPs were performed by a single experienced surgeon. High PPFA and prostate weight were independent factors that prolonged total OT and pneumoperitoneum time. High BMI was not a factor. PPFA affected steps 1, 4, 5, and 6, and prostate weight affected prolonged steps 5 and 6. Estimated blood loss, duration of urethral catheterization, postoperative hospital stay, perioperative complications, and margin status were not affected by visceral obesity. Conclusion PPFA was more useful to accurately predict prolonged OT than VFA or BMI. Safety and margin status were not compromised even in high PPFA group when operations were performed by an experienced surgeon.

UR - http://www.scopus.com/inward/record.url?scp=84888639571&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84888639571&partnerID=8YFLogxK

U2 - 10.1016/j.urology.2013.04.077

DO - 10.1016/j.urology.2013.04.077

M3 - Article

C2 - 24063935

AN - SCOPUS:84888639571

VL - 82

SP - 1304

EP - 1309

JO - Urology

JF - Urology

SN - 0090-4295

IS - 6

ER -