YMJ. 2012; 6(24): 559-566

ANESTHESIA FOR ROBOT- ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY: OUR 4- YEAR EXPERIENCE

Murat Haliloglu¹, Mehtap Ozdemir², Nurten Bakan^2
1Yeditepe University Hospital, Department of Anesthesiology and Reanimation
²Umraniye Education and Research Hospital, Department of Anesthesiology and Reanimation.
³Umraniye Education and Research Hospital, Department of Anesthesiology and Reanimation.

Purpose: To assess the feasibility and postoperative outcomes in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP) with pressure-controlled ventilation mode. Methods: 200 ASA physical status I, II, and III men underwent RALP was searched retrospectively. Demographic data, intraoperative hemodynamic and respiratory parameters and fluid and blood products, intraoperative and postoperative analgesic consumption were all recorded. Additional data included postoperative transfusion need; pre and postoperative hematocrit, platelet count, creatinine levels and length of hospital stay. Results: Mean age of the patients undergoing RALP was 62 years; mean body mass index was 28.2 kg m-2. The mean anesthesia time was 3.42 hours and mean blood loss was 222 ml. Postoperative anemia (hemoglobin ?10 g/ dL) requiring blood transfusions was seen in 4.1% of the patients. One patient required postoperative mechanical ventilation because of laryngeal edema secondary to multiple intubation attempts. Conclusions: RALP was associated with low estimated blood loss (EBL), few blood transfusions, PACU and short hospital stays.

Keywords: Robotic surgery; Steep Trendelenburg;Pressure-controlled- ventilation; Prostate cancer.

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ROBOT YARDIMLI LAPAROSKOPİK RADİKAL PROSTATEKTOMİ ANESTEZİSİ: 4 YILLIK DENEYİMLERİMİZ

Murat Haliloglu¹, Mehtap Ozdemir², Nurten Bakan^2
1Yeditepe University Hospital, Department of Anesthesiology and Reanimation
²Umraniye Education and Research Hospital, Department of Anesthesiology and Reanimation.
³Umraniye Education and Research Hospital, Department of Anesthesiology and Reanimation.

Amaç: Robot yardımlı laparoskopik radikal prostatektomi operasyonları sırasında uygulanan basınç kontrollü modun uygunluğunun ve postoperatif sonuçlarının değerlendirilmesi. Method: Robot yardımlı laparoskopik radikal prostatektomi operasyonu geçiren ASA I-III grubu 200 hasta retrospektif olarak değerlendirildi. Hastaların demografik verileri, intraoperatif hemodinamik ve respiratuvar- parametreleri, peroperatif analjezik tüketimi incelendi. Ayrıca hastaların peroperatif hematokrit düzeyleri, platelet sayıları, kreatinin seviyesi ve transfüzyon ihtiyacına bakıldı. Bulgular: Ortalama hasta yaşı 62 yıl, vücut kitle indeksi 28.2 kg m-2, anestezi süresi 3.42 saat, kan kaybı 222 ml bulundu. Hastaların % 4.1’inde kan transfüzyonu gerektiren postoperatif anemi (hemoglobin< 10 g/dl) görüldü. Çok sayıda entübasyon girişimi sonucu gelişen larenks ödemi nedeniyle bir hastada postoperatif mekanik ventilasyon ihtiyacı oluştu. Sonuç: Robot yardımlı laparoskopik radikal prostatektomi daha az kan kaybı, transfüzyon ihtiyacı, anestezi sonrası bakım ünitesi ve hastanede kalış süresi ile ilişkilidir.

Anahtar Kelimeler: Robotik cerrahi; Aşırı Trendelenburg; Basınç-kontrollü ventilasyon; Prostat kanseri.

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