Background: Robotic-assisted laparoscopic prostatectomy (RALP) gained much popularity during the last decade.\nAlthough the influence of intraoperative fluid management on patients� outcome has been largely discussed in\ngeneral, its impact on perioperative complications and length of hospitalization in patients undergoing RALP has\nnot been examined so far. We hypothesized that a more restrictive fluid management might lead to a shortened\nlength of hospitalization and a decreased rate of complications in our patients.\nMethods: Retrospective analysis of data of 182 patients undergoing RALP at an University Hospital (first series of\nRALP performed at the center).\nResults: The amount of fluid administered was initially normalized for body mass index of the patient and the\nduration of the operation and additionally corrected for age and the interaction of these variables. The application\nof crystalloids (multiple linear regression model, estimate = ?0.044, p = 0.734) had no effect on the length of\nhospitalization, whereas a negative effect was found for colloids (estimate = ?8.317, p = 0.021). Additionally, a\nsignificant interaction term between age and the amount of colloid applied (estimate = 0.129, p = 0.028) was\ncalculated. Evaluation of the influence of intraoperative fluid administration using multiple logistic regression\nmodels corrected for body mass index, duration of the surgery and additionally for age revealed a negative effect\nof crystalloids on the incidence of an anastomotic leak between bladder and urethra (estimate = ?23.860, p = 0.017),\nwith a significant interaction term between age and the amount of crystalloids (estimate = 0.396, p = 0.0134).\nColloids had no significant effect on this particular complication (estimate = 1.887, p = 0.524). Intraoperative blood\nloss did not alter the incidence of an anastomotic leak (estimate = 0.001, p = 0.086), nor did it affect the length of\nhospitalization (estimate = 0.0001, p = 0.351).\nConclusions: In accordance to the findings of our study, we suggest that a standardized, more restrictive fluid\nmanagement might be beneficial in patients undergoing RALP. In older patients this measure would be able to\nshorten the length of hospitalization and to decrease the incidence of anastomosis leakage as a major complication.
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