TY - JOUR
T1 - Incidence and risk factors of inguinal hernia after robot-assisted radical prostatectomy
T2 - a retrospective multicenter cohort study in Japan (the MSUG94 group)
AU - Toide, Masahiro
AU - Ebara, Shin
AU - Tatenuma, Tomoyuki
AU - Ikehata, Yoshinori
AU - Nakayama, Akinori
AU - Kawase, Makoto
AU - Sasaki, Takeshi
AU - Yoneda, Tatsuaki
AU - Sakaguchi, Kazushige
AU - Teishima, Jun
AU - Makiyama, Kazuhide
AU - Kitamura, Hiroshi
AU - Saito, Kazutaka
AU - Koie, Takuya
AU - Inoue, Takahiro
AU - Urakami, Shinji
AU - Koga, Fumitaka
N1 - Publisher Copyright:
© 2024, The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.
PY - 2024/12
Y1 - 2024/12
N2 - To investigate the incidence and risk factors of inguinal hernia (IH) after robot-assisted radical prostatectomy (RARP) using a multicentric database. The present study used a multicentric database (the MSUG94) containing data on 3,195 Japanese patients undergoing RARP between 2012 and 2021. Surgical procedures utilized for IH prevention were as follows: isolation of the vas deferens, transection of the vas deferens, isolation of the spermatic vessels, and separation of the peritoneum from the internal inguinal ring. The primary and secondary endpoints were IH-free survival and any association between post-RARP IH and clinical covariates. The prophylactic effect of the above procedures were also assessed. IH prevention was attempted in 1,465 (46.4%) patients at five of the nine hospitals. During follow-up (median 24 months), post-RARP IH developed in 243 patients. The post-RARP IH-free survival rates at years 1, 2, and 3 were 94.3%, 91.7%, and 90.5%, respectively. Old age (hazard ratio [HR] 1.037; 95% confidence interval [CI] 1.014–1.061; p = 0.001), low BMI (HR 0.904; 95% CI 0.863–0.946: p < 0.001), and low hospital volume (HR 1.385; 95% CI 1.003–1.902; p = 0.048) were independently associated with IH development. None of the procedures for IH prevention were associated with IH development. Our findings may represent the current, real-world status of post-RARP IH in Japan. The prophylactic effects of the surgical procedures for IH prevention should be further investigated in well-designed, prospective studies to optimize the surgical technique.
AB - To investigate the incidence and risk factors of inguinal hernia (IH) after robot-assisted radical prostatectomy (RARP) using a multicentric database. The present study used a multicentric database (the MSUG94) containing data on 3,195 Japanese patients undergoing RARP between 2012 and 2021. Surgical procedures utilized for IH prevention were as follows: isolation of the vas deferens, transection of the vas deferens, isolation of the spermatic vessels, and separation of the peritoneum from the internal inguinal ring. The primary and secondary endpoints were IH-free survival and any association between post-RARP IH and clinical covariates. The prophylactic effect of the above procedures were also assessed. IH prevention was attempted in 1,465 (46.4%) patients at five of the nine hospitals. During follow-up (median 24 months), post-RARP IH developed in 243 patients. The post-RARP IH-free survival rates at years 1, 2, and 3 were 94.3%, 91.7%, and 90.5%, respectively. Old age (hazard ratio [HR] 1.037; 95% confidence interval [CI] 1.014–1.061; p = 0.001), low BMI (HR 0.904; 95% CI 0.863–0.946: p < 0.001), and low hospital volume (HR 1.385; 95% CI 1.003–1.902; p = 0.048) were independently associated with IH development. None of the procedures for IH prevention were associated with IH development. Our findings may represent the current, real-world status of post-RARP IH in Japan. The prophylactic effects of the surgical procedures for IH prevention should be further investigated in well-designed, prospective studies to optimize the surgical technique.
KW - Inguinal hernia
KW - Multicenter study
KW - Prostate cancer
KW - Radical prostatectomy
KW - Robot-assisted radical prostatectomy
UR - http://www.scopus.com/inward/record.url?scp=85182451102&partnerID=8YFLogxK
U2 - 10.1007/s11701-023-01761-1
DO - 10.1007/s11701-023-01761-1
M3 - 学術論文
C2 - 38231428
AN - SCOPUS:85182451102
SN - 1863-2483
VL - 18
JO - Journal of Robotic Surgery
JF - Journal of Robotic Surgery
IS - 1
M1 - 38
ER -