The Effect of American Society of Anesthesiology Scores on Radical Prostatectomy Complications

Research Article

Austin J Urol. 2017; 4(1): 1055.

The Effect of American Society of Anesthesiology Scores on Radical Prostatectomy Complications

Yikilmaz TN¹* and Toksöz S²

¹Department of Urology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Turkey

²Department of Urology, Samandag State Hospital, Turkey

*Corresponding author: Yikilmaz TN, Department of Urology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Mehmet Akif Ersoy District 13.St. No:56, Yenimahalle, 06200, Ankara, Turkey

Received: December 12, 2016; Accepted: March 20, 2017; Published: March 29, 2017

Abstract

Objective: The objective of this study was to evaluate the effect of American society of Anesthesiology (ASA) scores on radical prostate ectomy complications

Methods: We retrospectively included 225 patients undergoing radical prostatectomy from 1999 to 2015. Patients were divided into a low-risk group with ASA of 1 or 2 and high risk group of ASA 3 or 4. Perioperative and postoperative complications were recorded using the modified clavien classification system.

Results: Following radical retropubicprostatectomy, there were 73 complications in 225 patients, with an overall complication rate of 32.4%. The most complication in all groups was blood transfusion in 31 patients (13.7%), and the most important complications were rectal injuries during RRP, with 4 patients (1.9%). Statistically significant difference was observed between the complication rates of the groups (25.4% versus 53.5%, p<0.05 respectively).

Conclusion: The expected results in the frequency of complication were not increased in patients with high Anesthesia (ASA) risk group. Systemic complications such as deep vein thrombosis, pulmonary embolism and infections often observed in the high ASA risk patients, surgery-related complications (such as bleeding with requiring blood transfusions, incontinence, urethral structure) are shown in both of groups. Therefore modified Clavien classification system and ASA score is not independently for each other. Using the two systems will be more accurate together. However, the failure to develop a standardized system for the classification of undesirable side effects, the Clavien system is still the most appropriate method despite all the short comings in urological surgery.

Introduction

Prostate Cancer (PC) represents a global health problem and the most frequently diagnosed cancer in men with 233000 new cases and 29480 cancer- specific deaths estimated for year 2014 in United States [1]. There are different treatment methods of prostate cancer. Radical prostatectomy and radiotherapy are considered as comparable treatments for localized PC [2]. Radical prostatectomy defined by Walsh and Donker, remains the most effective and widely used surgical intervention for localized prostate cancer and is considered the gold stand art treatment [3]. Radical prostatectomy administered by open (retropubic or perineal), laparoscopic or robotic approach.

Although improvements in surgical technique, peri and postperative management have reduced the complications of surgery, we can see complications because of the complexity of surgery. The Clavien classification system has been proposed as a mean of quantifying the complication of surgery, developed by Clavien and colleagues in 1992 and updated in 2004 [4]. It has been recently modified and named Modified Clavien Classification System (CCS) (Table 1) [5].