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- Angenete, Eva, 1972, et al.
(författare)
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Physical activity before radical prostatectomy reduces sick leave after surgery : results from a prospective, non-randomized controlled clinical trial (LAPPRO)
- 2016
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Ingår i: BMC Urology. - : Springer Science and Business Media LLC. - 1471-2490. ; 16:1, s. 50-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Studies have reported that early physical rehabilitation after surgical procedures is associated with improved outcome measured as shorter hospital stay and enhanced recovery. The aim of this study was to explore the relationship between the preoperative physical activity level and subsequent postoperative complications, sick-leave and hospital stay after radical prostatectomy for prostate cancer in the setting of the LAPPRO trial (LAParoscopic Prostatectomy Robot Open). METHODS: LAPPRO is a prospective controlled trial, comparing robot-assisted laparoscopic and open surgery for localized prostate cancer between 2008 and 2011. 1569 patients aged 64 or less with an occupation were included in this sub-study. The Gleason score was <7 in 52 % of the patients. Demographics and the level of self-assessed preoperative physical activity, length of hospital stay, complications, quality of life, recovery and sick-leave were extracted from clinical record forms and questionnaires. Multivariable logistic regression, with log-link and logit-link functions, was used to adjust for potential confounding variables. RESULTS: The patients were divided into four groups based on their level of activity. As the group with lowest engagement of physical activity was found to be significantly different in base line characteristics from the other groups they were excluded from further analysis. Among patients that were physically active preoperativelly (n = 1467) there was no significant difference between the physical activity-groups regarding hospital stay, recovery or complications. However, in the group with the highest self-assessed level of physical activity, 5-7 times per week, 13 % required no sick leave, compared to 6.3 % in the group with a physical activity level of 1-2 times per week only (p < 0.0001). CONCLUSIONS: In our study of med operated with radical prostatectomy, a high level of physical activity preoperatively was associated with reduced need for sick leave after radical prostatectomy compared to men with lower physical activity. TRIAL REGISTRATION: The trial is registered at the ISCRTN register. ISRCTN06393679 .
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| 3. |
- Derogar, Maryam, et al.
(författare)
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Preparedness for side effects and bother in symptomatic men after radical prostatectomy in a prospective, non-randomized trial
- 2016
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Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 55:12, s. 1467-1476
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many clinicians believe that preparedness before surgery for possible post-surgery side effects reduces the level of bother experienced from urinary incontinence and decreased sexual health after surgery. There are no published studies evaluating this belief. Therefore, we aimed to study the level of preparedness before radical prostatectomy and the level of bother experienced from urinary incontinence and decreased sexual health after surgery. MATERIAL AND METHODS: We prospectively collected data from a non-selected group of men undergoing radical prostatectomy in 14 centers between 2008 and 2011. Before surgery, we asked about preparedness for surgery-induced urinary problems and decreased sexual health. One year after surgery, we asked about bother caused by urinary incontinence and erectile dysfunction. As a measure of the association between preparedness and bothersomeness we modeled odds ratios (ORs) by means of logistic regression. RESULTS: Altogether 1372 men had urinary incontinence one year after surgery as well as had no urinary leakage or a small urinary dribble before surgery. Among these men, low preparedness was associated with bother resulting from urinary incontinence [OR 2.84; 95% confidence interval (CI) 1.59-5.10]. In a separate analysis of 1657 men we found a strong association between preparedness for decreased sexual health and experiencing bother from erectile dysfunction (OR 5.92; 95% CI 3.32-10.55). CONCLUSION: In this large-sized prospective trial, we found that preparedness before surgery for urinary problems or sexual side effects decreases bother from urinary incontinence and erectile dysfunction one year after surgery.
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| 4. |
- Erestam, Sofia, et al.
(författare)
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Associations between intraoperative factors and surgeons' self-assessed operative satisfaction.
- 2020
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Ingår i: Surgical endoscopy. - : Springer Science and Business Media LLC. - 1432-2218 .- 0930-2794. ; 34:1, s. 61-68
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Tidskriftsartikel (refereegranskat)abstract
- Little is known concerning what may influence surgeon satisfaction with a surgical procedure and its associations with intraoperative factors. The objective was to explore the relationships between surgeons' self-assessed satisfaction with performed radical prostatectomies and intraoperative factors such as technical difficulties and intraoperative complications as reported by the surgeon subsequent to the operation.We utilized prospectively collected data from the controlled LAPPRO trial where 4003 patients with prostate cancer underwent open (ORP) or robot-assisted laparoscopic (RALP) radical prostatectomy. Patients were included from fourteen centers in Sweden during 2008-2011. Surgeon satisfaction was assessed by questionnaires at the end of each operation. Intraoperative factors included time for the surgical procedure as well as difficulties and complications in various steps of the operation. To model surgeon satisfaction, a mixed effect logistic regression was used. Results were presented as odds ratios (OR) with 95% confidence intervals (CI).The surgeons were satisfied in 2905 (81%) and dissatisfied in 702 (19%) of the surgical procedures. Surgeon satisfaction was not statistically associated with type of surgical technique (ORP vs. RALP) (OR 1.36, CI 0.76; 2.43). Intraoperative factors such as technical difficulties or complications, for example, suturing of the anastomosis was negatively associated with surgeon satisfaction (OR 0.24, CI 0.19; 0.30).Our data indicate that technical difficulties and/or intraoperative complications were associated with a surgeon's level of satisfaction with an operation.
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| 9. |
- Stinesen-Kollberg, Karin, et al.
(författare)
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Psychological Well-being and Private and Professional Psychosocial Support After Prostate Cancer Surgery : A Follow-up at 3, 12, and 24 Months After Surgery
- 2016
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Ingår i: European Urology Focus. - : Elsevier BV. - 2405-4569. ; 23, s. S154-S154
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Tidskriftsartikel (refereegranskat)abstract
- Background Cross-sectional studies indicate that a cancer patient's partner is important in regard to the patient's psychological well-being. This has yet to be investigated in a large prospective setting. Objective To investigate types of psychosocial support and whether men improved their well-being at 12 and 24 mo after radical prostatectomy. Design, setting, and participants In a group of 1446 men participating in the Laparoscopic Prostatectomy Robot Open (LAPPRO) trial reporting low well-being 3 mo after surgery and who also had a more limited social network, we investigated predictors of change in well-being at 12 and 24 mo. Outcome measurements and statistical analysis Predictors of outcome were analyzed using log-binomial regression and forward regression. Results and limitations No one reported high well-being 3 mo after surgery. Of 1370 men reporting low well-being at 3 mo, 479 had improved to high well-being at 12 mo. At least one supportive person increased men's chances of improved well-being at 12 mo compared with 3 mo after surgery (relative risk [RR]: 1.32; 95% confidence interval [CI], 1.10–1.72), as did partner support (RR: 1.91; 95% CI, 1.28–2.86). The more people available for emotional and practical support, the more likely men were to improve their well-being at 12 and 24 mo, especially between 3 and 12 mo (p < 0.0001). A limitation is that RRs were influenced by variations in the metrics of patient-reported well-being. Conclusions The private network played a critical role regarding improved well-being. Having a partner and people to confide in within one's private network bettered patients’ chances of improved well-being. Helping men mobilize support within their private network early on may be important in the recovery process. Patient summary The link between one's private social network and well-being after prostate cancer surgery remains unclear. We investigated the role of support with many patients having undergone prostate cancer surgery. We found that the private social network was critical to men's well-being.
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| 10. |
- Stinesen-Kollberg, Karin, et al.
(författare)
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Social constraints and psychological well-being after prostate cancer : A follow-up at 12 and 24 months after surgery
- 2018
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Ingår i: Psycho-Oncology. - : Wiley. - 1057-9249 .- 1099-1611. ; 27:2, s. 668-675
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Studies indicate that social constraints (barriers to emotional expression) may be a risk factor for psychological morbidity. We aimed to investigate the association between prostate cancer–related social constraints and psychological well-being following prostate cancer surgery. Methods: In a group of 3478 partnered patients, participating in the Laparoscopic Prostatectomy Robot Open trial, a prospective multicenter comparative study of robot-assisted laparoscopic and retropubic radical prostatectomy for prostate cancer, we used log-binomial regression analysis to investigate the links between prostate cancer–related social constraints at 3 months after surgery and psychological well-being at 12 and 24 months. Results: A total of 1086 and 1093 men reported low well-being at 12 and 24 months, respectively. Prostate cancer-related social constraints by partner predicted low psychological well-being at 12 months (adjusted RR: 1.4; 95% CI, 1.1-1.9) and by others (adjusted RR: 1.9; 95% CI, 1.1-3.5). Intrusive thoughts mediated the association. Conclusions: Negative responses from the social environment, especially from partner to talking about the prostate cancer experience affected patients' psychological well-being 2 years after radical prostatectomy. Results emphasize the importance of helping patients mobilize psychosocial resources within their social network, especially among those with a lack of quality psychosocial support.
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