Blood viscosity has been considered in many studies as a major risk factor or a reliable predictor of cardiovascular or cerebrovascular disease. This blood viscosity is determined by the complex action of blood components, including red blood cells, white blood cells, platelets, fibrinogen, and various blood proteins. In particular, platelets and fibrinogen play an important role in the aggregation of red blood cells, which results in disturbance of peripheral blood circulation. Blood viscosity is greatly increased in diseases such as myocardial infarction and stroke, and efforts are made to decrease the number or function of hematocrit or fibrinogen as a treatment method to reduce blood viscosity. Thus, blood viscosity is an important factor closely related to the adequacy of blood circulation in patients.
 Patients diagnosed with prostate cancer have been treated with robotic laparoscopic surgery for less tissue damage than conventional prostate cancer surgery. However, robotic laparoscopic surgery requires a steep head down posture in addition to penumoperitoneum in order to obtain an operative visual field. In addition, patients with older and various comorbidity (ie, diabetes, hypertension, and angina) have undergone robotic laparoscopic surgery due to good outcomes after the surgery. These patients are expected to increase even more in the future.
 In conclusion, this study examines the changes in blood viscosity of patients during surgery and finds factors associated with increased blood viscosity. This will be an important data to reduce the risk of sudden increase in blood viscosity during surgery.

Cohort/Group Label

Patients undergoing robot-assisted laparoscopic prostatectomy with steep Trendelenburg position

Cohort/Group Description

Blood viscosity is measured three times during surgery that are immediately after anesthesia; after surgical position (i.e., steep Trendelenburg position with pneumoperitoneum); and immediately after perioneal closure in supine position in patients undergoing robot-assisted laparoscopic prostatectomy with steep Trendelenburg position

Not collect nor Archive

patients undergoing robot-assisted laparoscopic prostatectomy in Seoul St. Mary's hospital, 19 or more years old, ASA 1 or 2 group

Based on the number of 200 adult patients who underwent robotic-assisted laparoscopic prostate cancer surgery at Seoul St. Mary's Hospital from january 1, 2017 to December 31, 2017, we will collect 60 patient data and conduct a pilot study to investigate intraoperative changes in blood viscosity using simple random sampling.

Gender

Age

Description

1. Robotic-assisted laparoscopic prostate cancer surgery at Seoul St. Mary's Hospital
2. Adults (age more than 19 years-old)
3. American Society of Anesthesiologists grade 1 or 2

1. Disagreement to participate in this study
2. Emergency surgery
3. Children (under 19 years old)
4. American Society of Anesthesiologists grade 3, 4 or 5
5. Massive hemorrhage to require colloid infusion or blood transfusion during surgery
6. Severe hemodynamic instability to require vasopressors infusion during surgery

Blood viscosity

1. Immediately after general anesthesia (Supine position); 2. 30 minute after surgical position (Steep Trendelenburg position with pneumoperitoneum); 3 . Immediately before surgery (Supine position)

Correlations of intraoperative blood viscosity with preoperative clinical factors, such as gender, age, height, weight, body mass index, diabetes mellitus, hypertension, hepatitis, tuberculosis, abdominal surgical history, smoking history, prostate cancer stage, white blood cell count, red blood cell count, hemoglobin, hematocrit, platelet count, neutrophil, lymphocyte, monocyte, eosinophil, basophil, MCV, MCH, MCHC, glucose, urea nitrogen, creatinine, total protein, albumin, AST, ALT, alkaline phosphatase, total bilirubin, uric acid, calcium, sodium, potassium, chloride, total cholesterol, triglyceride, HDL, LDL, prothrombin time, international normalized ratio, activated partial thrombin time, fibrinogen, D-dimer, FDP

Date of the final analysis of the data

Correlations of intraoperative blood viscosity with intraoperative clinical factors, such as total surgery duration, total amount of fluid infusion, toal urine output, blood pressure, heart rate, body temperature, central venous pressure

Date of the final analysis of the data

all-causes morbidity and mortality; and total hospital administration duration

During hospital administration after the surgery