The Functional and Oncological Outcomes of 242 cases of Extraperitoneal Laparoscopic Radical Prostatectomy
Keywords:functional, oncological, extraperitoneal, laparoscopic, radical prostatectomy
Objectives: We report the outcome of 242 cases of extraperitoneal laparoscopic radical prostatectomy performed by a single surgeon.
Methods: 242 patients with localized and locally advanced prostate cancer, who underwent extraperitoneal laparoscopic radical prostatectomy. Perioperative data, functional and oncological outcomes were evaluated.
Results: Average patients age was 66.67 years (range 42-83 years), and mean preoperative PSA level was 19.39 ng/ml (range 0.44-421 ng/ml). The mean operative time was 220 minutes. The mean intraoperative blood loss was 776.26 ml (range 50- 5,500 ml). 29.3% of cases were received blood transfusion. Margin positive rate was reported in pT2 and pT3 with 13.30% and 56.1%, respectively. The mean catheterization time and hospital stay duration were 9.73 days and 8.76 days, respectively. Continence outcome on 1st, 3rd, 6th, 12th month were 17.4%, 33%, 54% and 67.4%, respectively. 26 patients underwent nerve sparing procedure in patients younger than 60 years and the results in potency rate at 3, 6, 9 and 12 months were 7.7%, 27.8%, 41.2% and 69.2%, respectively.
Conclusions: Extraperitoneal laparoscopic radical prostatectomy is the minimally invasive surgery of prostate cancer benefits for pT2 staging with the good oncological outcomes and functional outcomes.
Bollens R, Vanden Bossche M, Roumeguere T, Damoun A, Ekane S, Hoffmann P, et al. Extraperitoneal laparoscopic radical prostatectomy. Results after 50 cases. Eur Urol. 2001 Jul; 40(1): 65-9.
Stolzenburg JU, Rabenalt R, DO M, Ho K, Dorschner W, Waldkirch E, et al. Endoscopic extraperitoneal radical prostatectomy: oncological and functional results after 700 procedures. J. Urol. 2005 Oct;174(4 Pt 1):1271-5; discussion 1275.
Rozet F, Galiano M, Cathelineau X, Barret E, Cathala N, Vallancien G. Extraperitoneal laparoscopic radical prostatectomy: a prospective evaluation of 600 cases. J Urol 2005; 174: 908-11.
Nualyong C, Srinualnad S, Taweemonkongsap T, Amornvesukit T. Lap-aroscopic radical prostatectomy. J Med Assoc Thai 2006; 89: 1440-6.
Paul A, Ploussard G, Nicolaiew N, Xylinas E, Gillion N, de la Taille A, et al. Oncologic Outcome after Extraperitoneal Laparoscopic Radical Prostatectomy: Midterm Follow-up of 1115 Procedures. Eur Urol. 2009 Sep 17.
Stolzenburg JU, Kallidonis P, Minh D, Dietel A, Hafner T, Dimitriou D, et al. Endoscopic extraperitoneal radical prostatectomy: evolution of the technique and experience with 2400 cases. J Endourol. 2009 Sep; 23(9): 1467-72.
Srinualnad S, Udompunturak S. Extraperitoneal laparoscopic radical prostatectomy: early experience in Thailand. Asian J.Surg. 2007 Oct; 30(4): 272-7.
Ficarra V, Novara G, Artibani W, Cestari A, Galfano A, Graefen M, et al. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies. Eur.Urol. 2009 Jan; 55: 1037-63.
Touijer K, Eastham JA, Secin FP, Romero Otero J, Serio A, Stasi J, et al. Comprehensive prospective comparative analysis of outcomes between open and laparoscopic radical prostatectomy conducted in 2003 to 2005. J Urol 2008; 179: 1811-7.
Srinualnad S. Robotic Assisted Laparoscopic Radical Prostatectomy: When cure can come with quality of life. Thai J Urol 2009; 30(2): 47-51.