Robotic-assisted surgery is safe for patients with metabolic syndrome

The authors examined whether it is safe to use robot-assisted surgery in prostate cancer patients who have metabolic syndrome. 

Metabolic syndrome consists of a cluster of conditions that occur together and increase the risk of stroke, heart disease and diabetes. The main sign of metabolic syndrome is excess body fat located around the waste (central obesity). Other signs include increased blood pressure, high blood sugar levels, and abnormal cholesterol levels. Metabolic syndrome is common for adults in the United States with prevalence rates between 26.7% and 40.1%. For this reason, it is important to know whether metabolic syndrome can increase the risk of problems during or after surgical removal of the prostate. 

This study included 1,244 patients with localized prostate cancer (the cancer had not spread beyond the prostate). Patients were treated with robotic-assisted laparoscopic prostatectomy (RALP: robot assisted minimally invasive surgical removal of the prostate). Overall 46.7% were obese (body mass index (BMI) ≥ 30); 14.7% were obese with no symptoms of metabolic syndrome, 16.9% were obese with 1 symptom of metabolic syndrome, and 15% were obese with metabolic syndrome.

When patients with metabolic syndrome were compared to non-obese patients (53.3%) no difference was found in the cancer grade (how the cancer cells look under the microscope), spread of the cancer, level of surgical complication, erectile function or follow-up time. However, having metabolic syndrome increased the odds of having a larger prostate by 47.7%. It also increased the odds of having greater blood loss during surgery by 59.3% and the odds of having a more complex surgery by 4.9 times compared to non-obese patients.

The authors concluded that RALP is safe, feasible and efficacious in men with localized prostate cancer who have metabolic syndrome. However, the surgery may be more complex and likely require greater surgical expertise.

This was a retrospective study (evaluating patient records only) which may limit how generalizable the results are.