Laparoscopic radical Prostatectomy : Can we do it in province hospital.

Abstract

Objective : Laparoscopic radical prostatectomy has been introduced as a minimal invasive alternative to open radical prostatectomy. In Thailand, several published series from university hospital demonstrated that laparoscopic radical prostatectomy is efficacy and safty. We report our initial experience of laparoscopic radical prostatectomy in Prapokklao hospital: Regional hospital, Chanthaburi.

Method : From January 2008 to December 2009, tranperitoneal laparoscopic radical prostatectomy was performed on 7 men who were candidates for radical prostatectomy. Patient characteristic,perioperative data, pathologic result were prospectively collected.

Result : Mean age of the patients was 70.5 years [65-77], mean preoperative prostatic antigen level was 44 [range 2-85]. The mean operative time was 4.8 hours [range 3 to 6 ]. Blood loss average was 850 ml [range 200-2,000ml], and 3 patients received blood transfusions. One patient have intraoperative bleeding, no conversion to open surgery. Post operative complications were seen in 2 patients [AUR and UTI]. At 1 month follow-up,
all patients had used 0-1 pad per day but all patients had erectile dysfunction. Positive surgical margins were reported in 4 specimens [all patient in T3]

Conclusion: Laparoscopic radical prostatectomy is safe and feasible alternative to retropubic radical prostatectomy in provincial hospital. Laparoscopic approach required steep learning curve, selected patient, proper equipments and good surgical team.