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Age, obesity, medical comorbidities and surgical technique are predictive of symptomatic anastomotic strictures after contemporary radical prostatectomy.

By:
Contributors: Geoffrey Gotto, MD
J Urol. 2011 Jun;185(6):2148-52. doi: 10.1016/j.juro.2011.02.003. Epub 2011 Apr 15.

Abstract

PURPOSE:

Anastomotic strictures are relatively common after radical prostatectomy and are associated with significant morbidity, often requiring multiple surgical interventions. There is controversy in the literature regarding which factors predict the development of anastomotic strictures. In this study we determined predictors of symptomatic anastomotic strictures following contemporary radical prostatectomy.

MATERIALS AND METHODS:

Between 1999 and 2007, 4,592 consecutive patients underwent radical prostatectomy without prior radiotherapy at our institution. Data were collected from prospective surgical and institutional morbidity databases, and retrospectively from inpatient and outpatient medical and billing records. Cases were assigned a Charlson score to account for comorbidities. Complications were graded according to the modified Clavien classification.

RESULTS:

Open radical prostatectomy was performed in 3,458 men (75%) and laparoscopic radical prostatectomy was performed in 1,134 (25%). The laparoscopic radical prostatectomy group included 97 robotic-assisted cases. Median patient age was 59.5 years (IQR 54.7, 64.2). Symptomatic anastomotic strictures developed in 198 patients (4%) after a median postoperative followup of 3.5 months (IQR 2.1, 6.1). On multivariate analysis significant predictors included patient age, body mass index, Charlson score, renal insufficiency, individual surgeon, surgical approach and the presence of postoperative urine leak or hematoma.

CONCLUSIONS:

Patient factors as well as technical factors influence the development of symptomatic anastomotic strictures following contemporary radical prostatectomy. The impact of these factors is influenced by the individual surgeon and the approach used.

 

PubMed

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Dr. John Lewis recognized for a breakthrough innovation with commercial application: ClarityDX Prostate

Alberta’s life sciences industry association; BioAlberta, hosted its 2018 awards gala in Calgary, September 24. BioAlberta honoured Dr. John Lewis, the Frank and Carla Sojonky Chair in Prostate Cancer Research and an Associate Professor at the University of Alberta, with its Scientific Achievement and Innovation Award.

The Scientific Achievement and Innovation award recognizes an individual or a team responsible for a breakthrough innovation with commercial application. John Lewis and his research team based with his spin-off company Nanostics Inc. developed ClarityDX Prostate, a blood test designed to accurately diagnose aggressive prostate cancer. ClarityDX Prostate will give clinicians and physicians another tool to help them and their patients decide to perform a biopsy, or not. When the test becomes commercially available it is expected to reduce the number of prostate biopsies by 50%.

BioAlberta also gave out The Company of the Year award to Circle Cardiovascular Imaging Inc. for significant achievement within the marketplace and Alberta’s business community. It has developed technology to produce an innovative post-processing cardiovascular imaging solution to improve patient outcomes that provides fast, accurate and reproducible images to assist physicians in earlier diagnosis and treatment.

Mel Wong, President and CEO of BioAlberta presented the awards with these comments, “We commend Circle Cardiovascular Imaging and Dr. John Lewis for their exceptional achievements in life sciences, Alberta’s life sciences industry is maturing and these award winners exemplify Alberta’s capacity for global impact.”

More than 200 representatives from industry, the investment community, government and innovation support organizations attended the awards gala that was held in partnership with TEC Edmonton, and with generous event sponsors. Read more in this Financial Post article.

Congratulations to John Lewis on receiving BioAlberta’s Scientific Achievement and Innovation Award!

- Perrin Beatty