PERIOPERATIVEBLOODLOSS INOPENRETROPUBICRADICAL PROSTATECTOMY- IS ITSAFE TOGETOPERATED AT ANEDUCATIONALHOSPITAL?

Introduction: Blood loss during radical prostatectomy has been a long term issue. The aim of this study was toinvestigatetheinfluenceof thetraininglevelof the first assistant regarding blood loss in open retropubic radicalprostatectomyataneducationalhospital. Material and Methods: 364 patients underwent radical prostatectomy from 11/2006 to 10/2007 at one institution operated by one surgeon. In 319 patients all predefined parameters were obtained. Training level was determined by year of residency (1-5yrs) or consultant status. Perioperative blood loss was calculated using three parameters: Hemoglobin level before and after surgery, postoperative sucker volume and weight of compresses. Furthermore the influence of prostaticsizeandBMIwasanalyzed. Results: The Hb-decrease 24h postoperatively was 2.4g/dl median (-0.4-7.6g/dl); sucker volume was 250 ml median (10-1500ml); weight of compresses and swabs was 412g median (0-972g). One patient needed a transfusion with two erythrocyte concentrates one dayafterthesurgery.TherewasnosignificantcorrelationregardingHb-decrease(p=0.86)orsuckervolume plus weight of compresses (p=0.59) in regard to the years of residency of the assisting physician. Also the number of assisted operations (n= 20) had no significantinfluenceoncalculatedbloodloss(p=0.38). Conclusions: Foranexperiencedsurgeontheimpactof the assistant regarding blood loss seems negligible. Thetraininglevelof theassistantwasnotsignificantly correlated to a rise or decrease of perioperative blood loss. In our data radical prostatectomy could be safely performed at an educational hospital independent of thetraininglevelof thefirstassistant.