Purpose

The aim of the present study was to investigate whether renal dysfunction following rhabdomyolysis occurs after robot-assisted radical prostatectomy (RARP), and to investigate the factors related to rhabdomyolysis after RARP.

Methods

A total of 180 consecutive patients who underwent RARP at our institution were investigated. Rhabdomyolysis was defined as creatine kinase (CK) > 1050 IU/L after RARP. The association between CK and renal function after RARP was investigated, and the factors related to rhabdomyolysis after RARP were also investigated.

Results

Postoperative CK (407 ± 936 IU/L) was significantly higher than preoperative CK (134 ± 75 IU/L) (p < 0.001), and eGFR after RARP was significantly negatively correlated with CK on the day after RARP (correlation coefficient (ρ) = − 0.248, p = 0.007), but the significant negative correlation disappeared on the 7th day after RARP (ρ = − 0.010, p = 0.32). On multivariate analysis, postoperative CK elevation was significantly correlated with console time (p = 0.002). Rhabdomyolysis was observed in 6.1% (11/180), and of the patients with rhabdomyolysis, acute renal failure was transiently observed in 45.5% (5/11). On multivariate analysis, rhabdomyolysis was significantly associated with higher body mass index (BMI) (> 25.7 kg/m²) and longer console time (> 188 min) (p = 0.02 and p = 0.005, respectively).

Conclusion

Temporary renal dysfunction can occur after RARP due to CK elevation. Thus, sufficient attention must be paid to renal insufficiency after elevation of CK values for several days after RARP. Because rhabdomyolysis after RARP was associated with both obesity and long console time, console time during RARP should be shortened, especially in patients with obesity.

中文翻译：

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机器人辅助根治性前列腺切除术后因横纹肌溶解引起的短暂性肾功能不全。

目的

本研究的目的是调查机器人辅助根治性前列腺切除术（RARP）后横纹肌溶解后是否发生肾功能不全，并探讨与RARP后横纹肌溶解有关的因素。

方法

我们的机构共调查了180位接受RARP的连续患者。横纹肌溶解定义为RARP后肌酸激酶（CK）> 1050 IU / L。研究了RARP后CK与肾功能的关系，并探讨了RARP后横纹肌溶解的相关因素。

结果

术后CK（407±936 IU / L）明显高于术前CK（134±75 IU / L）（p  <0.001），RARP后第二天的eGFR与CK呈显着负相关（相关系数（ρ）= − 0.248，p  = 0.007），但显着负相关在RARP后第7天消失（ρ  = − 0.010，p  = 0.32）。在多因素分析中，术后CK升高与控制台时间显着相关（p = 0.002）。横纹肌溶解症的发生率为6.1％（11/180），横纹肌溶解症的患者中，短暂性肾衰竭的发生率为45.5％（5/11）。在多变量分析中，横纹肌溶解与更高的体重指数（BMI）（> 25.7 kg / m ²）和更长的安慰时间（> 188 min）显着相关（分别为p  = 0.02和p  = 0.005）。

结论

由于CK升高，RARP后可能发生暂时性肾功能不全。因此，在RARP后数天CK值升高后，必须充分注意肾功能不全。由于RARP后的横纹肌溶解症与肥胖和较长的安慰时间有关，因此应缩短RARP期间的安慰时间，尤其是在肥胖患者中。