Comparison of cognitive function after robot-assisted prostatectomy and open retropubic radical prostatectomy: A prospective observational single-center study

TY - JOUR

T1 - Comparison of cognitive function after robot-assisted prostatectomy and open retropubic radical prostatectomy: A prospective observational single-center study

AU - Beck, Stefanie

AU - Zins, Linnea

AU - Holthusen, Clara

AU - Rademacher, Cornelius

AU - von Breunig, Franziska

AU - Tennstedt, Pierre

AU - Haese, Alexander

AU - Graefen, Markus

AU - Zöllner, Christian

AU - Fischer, Marlene

N1 - Copyright © 2020 Elsevier Inc. All rights reserved.

PY - 2020/5

Y1 - 2020/5

N2 - OBJECTIVE: To assess the effects of robot-assisted radical prostatectomy in the Trendelenburg position on postoperative neurocognitive outcomes this study compared cognitive function between patients who underwent robot-assisted radical prostatectomy and those who underwent open retropubic radical prostatectomy.METHODS: Objective evaluations of pre- and postoperative cognitive function were performed upon admission and before hospital discharge, by using a neuropsychological test battery. We collected self-reported data on cognitive failures at 3 months postoperatively. Binary logistic regression analysis was used to assess the effects of surgical technique on postoperative cognitive performance.RESULTS: The pre- and postoperative neuropsychological assessments were completed by 367 patients with a median age of 64 years (range 44-76). The incidence of postoperative cognitive dysfunction was 23.9% after robot-assisted (39/165) and 22.3% after open radical prostatectomy (45/202). There was no significant difference in postoperative cognitive function during the early postoperative period (p=0.758) and self-reported cognitive failures at 3 months (p=0.303) between robot-assisted and open surgery. Surgical technique was not associated with early postoperative cognitive dysfunction in multivariable analysis (OR 1.012, 95% CI: 0.608-1.685, p=0.962).CONCLUSION: Compared with open surgery in supine position postoperative neurocognitive disorders do not occur more frequently after robot-assisted radical prostatectomy in the extreme Trendelenburg position. Based on these findings potential adverse effects on cognitive function do not have to be considered in the choice of surgical approach for radical prostatectomy.

AB - OBJECTIVE: To assess the effects of robot-assisted radical prostatectomy in the Trendelenburg position on postoperative neurocognitive outcomes this study compared cognitive function between patients who underwent robot-assisted radical prostatectomy and those who underwent open retropubic radical prostatectomy.METHODS: Objective evaluations of pre- and postoperative cognitive function were performed upon admission and before hospital discharge, by using a neuropsychological test battery. We collected self-reported data on cognitive failures at 3 months postoperatively. Binary logistic regression analysis was used to assess the effects of surgical technique on postoperative cognitive performance.RESULTS: The pre- and postoperative neuropsychological assessments were completed by 367 patients with a median age of 64 years (range 44-76). The incidence of postoperative cognitive dysfunction was 23.9% after robot-assisted (39/165) and 22.3% after open radical prostatectomy (45/202). There was no significant difference in postoperative cognitive function during the early postoperative period (p=0.758) and self-reported cognitive failures at 3 months (p=0.303) between robot-assisted and open surgery. Surgical technique was not associated with early postoperative cognitive dysfunction in multivariable analysis (OR 1.012, 95% CI: 0.608-1.685, p=0.962).CONCLUSION: Compared with open surgery in supine position postoperative neurocognitive disorders do not occur more frequently after robot-assisted radical prostatectomy in the extreme Trendelenburg position. Based on these findings potential adverse effects on cognitive function do not have to be considered in the choice of surgical approach for radical prostatectomy.

U2 - 10.1016/j.urology.2019.12.045

DO - 10.1016/j.urology.2019.12.045

M3 - SCORING: Journal article

C2 - 32084412

VL - 139

SP - 110

EP - 117

JO - UROLOGY

JF - UROLOGY

SN - 0090-4295

ER -