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Preoperative bullae and subsequent pneumothorax in 6605 patients who underwent robotic prostatectomy

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Abstract

Purpose

Robotic prostatectomy is the most common surgical approach for treating prostate cancer. Patients undergoing robotic prostatectomy may have bullae, which may rupture leading to pneumothorax. We evaluated the incidence of pneumothorax due to preoperative bullae rupture in robotic prostatectomy.

Methods

A large retrospective study of patients who underwent robotic prostatectomy between 2009 and 2021 was conducted. Bullae were detected using chest computed tomography. Pneumothorax was detected using a chest X-ray. The primary outcome was the incidence of pneumothorax due to bullae rupture. Secondary outcomes were the prevalence of preoperative bullae and the evaluation of postoperative outcomes, including length of hospital stay, intensive care unit admission rate, and prolonged intensive care unit stay (> 2 days).

Results

A total of 6605 patients were included. The prevalence of preoperative bullae was 3.0% (196/6,605). There was no incidence of pneumothorax due to bullae rupture. No significant difference in the incidences of pneumothorax between patients with and without bullae (0/196 vs. 2/6,409, P > 0.999) was observed. In addition, length of hospital stay, intensive care unit admission rate, and prolonged intensive care unit stay were not significantly different between the two groups. Kaplan–Meier analysis showed that there was no significant difference in lengths of hospital stay between the two groups (log-rank test, P > 0.999).

Conclusion

In our cohort, there was no incidence of pneumothorax following robotic prostatectomy in patients with preoperative bullae. This result could help in the management of patients with prostate cancer with bullae.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Jihion Yu, Jun-Young Park, Jiwoong Lee, Sunyoung Ha & Young-Kug Kim

  2. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Jun Hyuk Hong

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  1. Jihion Yu
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  2. Jun-Young Park
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  3. Jiwoong Lee
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  4. Sunyoung Ha
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  5. Jun Hyuk Hong
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Correspondence to Young-Kug Kim.

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Supplementary Information

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540_2022_3111_MOESM1_ESM.jpg

Supplementary file1 Comparison of the incidences of pneumothorax between patients with and without bullae. Note that there is no significant difference in the incidences of pneumothorax between patients with and without bullae (JPG 1386 KB)

540_2022_3111_MOESM2_ESM.jpg

Supplementary file2 Kaplan–Meier analysis for lengths of hospital stay between patients with and without bullae. Note that there is no significant difference in the lengths of hospital stay between patients with and without bullae (JPG 2709 KB)

Supplementary file3 (DOCX 27 KB)

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Yu, J., Park, JY., Lee, J. et al. Preoperative bullae and subsequent pneumothorax in 6605 patients who underwent robotic prostatectomy. J Anesth 36, 740–746 (2022). https://doi.org/10.1007/s00540-022-03111-1

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  • DOI: https://doi.org/10.1007/s00540-022-03111-1

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