• 2022-09
  • 2022-08
  • 2022-07
  • 2022-06
  • 2022-05
  • 2022-04
  • 2020-08
  • 2020-07
  • 2018-07
  • br charges Finally no differences


    257 charges. Finally, no differences in mortality rates were recorded. In consequence, our findings
    258 validate the feasibility and safety of robotically-assisted CRP relative to open CRP, within a large
    259 population-based cohort of contemporary North American patients. However, due to missing
    260 prospective studies demonstrating a survival advantage for CRP relative to no local treatment in
    261 mPCa patients, CRP, regardless of the used approach, should only be performed inside of clinical
    262 trials and does not represent the current standard of care for mPCa patients.
    264 retrospective analysis with all of its inherent limitations. Even though retrospective analyses usually
    265 meet with criticism, it should be noted that no prospective trial, comparing complications between
    266 robotically-assisted and open CRP, is ongoing, designed or even planned. The conduct of such trial
    267 is unlikely in the near future. In consequence, retrospective data from large population-based data
    268 repositories will provide the most robust and generalizable evidence for robotically-assisted relative
    269 to open CRP. Additionally, it should be noted that the definition of CRP is not standardized and the
    270 definition of mPCa patients undergoing CRP through coding ICD might be inaccurate and
    272 Beside its retrospective nature, our study also suffers of several other limitations that are
    273 inherent to population-based analyses. For example, we were unable to adjust for tumor
    274 characteristics. It could be argued that open CRP patients harbored more advanced prostate cancer
    275 stages, which could adversely affect intraoperative and postoperative complication rates. In
    276 consequence, adjustment for tumor stage, 3-Methyladenine node metastases, as well as lymph node dissection
    277 extent, which might have been more extensive in open CRP patients, could have influenced the
    278 complication rates. Moreover, we were also unable to adjust for patient characteristics, such as
    279 performance status, American Society of Anesthesiologists status, differences in laboratory values
    280 and opioid use, as well as presence or absence of exposure to neoadjuvant chemotherapy, androgen 13
    281 deprivation and radiotherapy. This said, despite multivariable adjustments are residual selection
    282 bias may have cofounded our results. Moreover, ideally a grading system for complications, such as
    283 the Clavien-Dindo system, should be used when surgical outcomes are observed 25. However, this
    284 information is unavailable in large data repositories such as the NIS. Finally, only inpatients
    285 information’s were available in the database we analyzed and no data were available regarding
    286 readmissions and late complications 17. Last but not least, vas deferens should be underlined that our study is
    287 not able to provide any information regarding the oncologic outcomes of open vs. robot assisted
    288 CRP, as well as that no information on positive surgical margins and data on surgeons’ experience
    289 is available within the NIS.
    293 In conclusion, the intraoperative and postoperative complications associated with robotically-
    294 assisted CRP are lower than those of open CRP. Similarly, robotically-assisted CRP is associated
    295 with shorter stay. Conversely, an increase in total hospital charges is associated with robotically-
    296 assisted CRP. Nonetheless, robotically-assisted CRP complication profile validates its safety and