A comparison of laparoscopic and retropubic radical prostatectomy – a single center experience
Authors:
Miloš Broďák; Josef Košina; Petr Hušek; Michal Balík; Lukáš Holub; Miloslav Louda; Jaroslav Pacovský
Authors‘ workplace:
Urologická klinika FN a LF UK, Hradec Králové
Published in:
Ces Urol 2012; 16(4): 222-229
Category:
Original article
Overview
Aim:
The aim of this study was to evaluate surgical outcomes of laparoscopic radical prostatectomy and compare them to retropubic radical prostatectomy.
Methods:
A cohort of 225 patients was evaluated. All patients underwent radical prostatectomy between January 2008 and April 2010. Retropubic radical prostatectomy was performed in 125 cases and laparoscopic surgery was performed in 100 cases. Surgical results and complications were compared between the two methods. In addition, the first and the last 25 laparoscopic surgeries were compared.
Results:
The median follow up time was 14 months, the median age was 62 years, the median PSA was 9 ng/mL and the median Gleason score was 7. The median duration of surgery using the laparoscopic approach was 3 hours and 20 minutes compared to 2 hours and 30 minutes using the retropubic approach. The estimated blood loss using the laparoscopic approach was 250 mL and using the retropubic method was 400 mL.
Conclusions:
The laparoscopic method for radical prostatectomy was an equivalent alternative to the open retropubic approach. Both procedures achieved comparable oncological and functional outcomes. The blood loss was significantly lower using the laparoscopic approach. This method was less invasive and allowed for a shorter recovery period.
Key words:
laparoscopic radical prostatectomy, prostate cancer, retropubic radical prostatectomy.
Sources
1. Ferlay J, Autier P, Boniol M, Heanue M, Colombet M, Boyle P. Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol. 2007; 18: 581–592.
2. Nelen V. Epidemiology of prostate cancer. Recent Results Cancer Res 2007; 175: 1–8.
3. Dušek L, Mužík J, Gelnarová J. Cancer Incidence and Mortality in the Czech Republic. Klin Onkol 2010; 23: 311–324.
4. Walsh PC. The discovery of the cavernous nerves and development of nerve sparing radical retropubic prostatectomy. J Urol 2007; 177: 1632–1635.
5. Walsh PC. Anatomic radical prostatectomy: evolution of the surgical technique. J Urol 1998; 160: 2418–2424.
6. Jarolím L. Neurovascular sparing radical prostatectomy Čas. Lék. čes. 1990; 129: 340–342.
7. Jarolím L, Kawaciuk I, Hanek P, Hyršl L, Dušek P, Jerie J, Schmidt M, Kaliská V, Fabišovský M, Rejchrt M. Funkční výsledky radikálních retropubických prostatektomií Ces Urol 2005; 9: 20–25.
8. Pacík D, Walsh PC. Radikální retropubická prostatektomie – nejúčinnější a nejméně zatěžující metoda pro vyléčení lokalizovaného karcinomu prostaty I. Urolog pro praxi 2002; 5: 193–199.
9. Pacík D, Walsh PC. Radikální retropubická prostatektomie – nejúčinnější a nejméně zatěžující metoda pro vyléčení lokalizovaného karcinomu prostaty II. Urolog pro praxi 2002; 6: 252–257.
10. Guillonneau B, Vallancien G. Laparoscopic radical prostatectomy: The Montsouris experience. J Urol 2000; 163: 418–422.
11. Rassweiler J, Sentker I, Seemann O, Hatzinger M, Stock C, Frede T. Heilbron laparoscopic radical prostatectomy: technique and results after 100 cases. Eur Urol 2001; 40: 54–64.
12. Stolzenburg JU, Kallidonis P, Minh D, Dietel A, Häfner T, Dimitriou D, Al-Aown A, Kyriazis I, Liatsikos EN. Endoscopic extraperitoneal radical prostatectomy: evolution of the technique and experience with 2400 cases. J Endourol 2009; 23: 1467–1472.
13. Stolzenburg JU, Liatsikos EN, Rabenalt R, Do M, Sakelaropoulos G, Horn LC, Truss MC. Nerve sparing endoscopic extraperitoneal radical prostatectomy – effect of puboprostatic ligament preservation on early continence and positive margins. Eur Urol 2006; 49(1): 103–111.
14. Broďák M, Košina J, Všetička J, Holub L, Hušek P, Pacovský J. Extraperitoneální laparoskopická radikální prostatektomie. Urolog. pro Praxi 2011; 12: 50–54.
15. Tewari AK, Srivastava A, Sooriakumaran P, Slevin A, Grover S, Waldman O, Rajan S, Herman M, Berryhill R. Jr., Leung R. Use of a novel absorbable barbed plastic surgical suture enables a „self-cinching“ technique of vesicourethral anastomosis during robot-assisted prostatectomy and improves anastomotic times. J Endourol 2010; 24(10): 1645–1650.
16. Zorn KC, Widmer H, Lattouf JB, Liberman D, Bhojani N, Trinh QD, Sun M, Karakiewicz PI, Denis R, El-Hakim A. Novel method of knotless vesicourethral anastomosis during robot-assisted radical prostatectomy: feasibility study and early outcomes in 30 patients using the interlocked barbed unidirectional V-LOC180 suture. Can Urol Assoc J 2011; 5(3): 188–194.
17. Stolzenburg JU, Do M, Kallidonis P, Ghulam N, Hellawell G, Haefner T, Liatsikos EN. Hemostasis during nerve-sparing endoscopic extraperitoneal radical prostatectomy. J Endourol 2010; 24(4): 505–509.
18. Stolzenburg JU, Rabenalt R, Do M, Lee B, Truss MC, McNeill A, Burchardt M, Jonas U, Liatsikos EN. Complications of endoscopic extraperitoneal radical prostatectomy (EERPE): prevention and management. World J Urol 2006; 24(6): 668–675.
19. Remzi M, Klingler HC, Tinzl MV, Fong YK, Lodde M, Kiss B, Marberger M. Morbidity of laparoscopic extraperitoneal versus transperitoneal radical prostatectomy verus open retropubic radical prostatectomy. Eur Urol 2005; 48(1): 83–89.
20. Brown JA, Rodin D, Lee B, Dahl DM. Transperitoneal versus extraperitoneal approach to laparoscopic radical prostatectomy: an assessment of 156 cases. Urology 2005; 65(2): 320–324.
21. Ficarra V, Novara G, Artibani W, Cestari A, Galfano A, Graefen M, Guazzoni G, Guillonneau B, Menon M, Montorsi F, Patel V, Rassweiler J, Van Poppel H. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies. Eur Urol 2009; 55(5): 1037–1063.
22. Doležel J, Tvarůžek J, Staník M, Zachoval R, Šimoník I, Korsa M, Vagunda V. Časné zkušenosti s roboticky asistovanou laparoskopickou radikální prostatektomií – prvních 153 pacientů. Ces Urol 2009; 13(2): 168–177.
23. Kolombo I, Beňo P, Toběrný M, Bartůněk M, Tobiáš J. Laparoskopická robotická daVinci radikální prostatektomie – naše první zkušenosti. Urologie pro Praxi 2007; 6: 20–26.
24. Kolombo I, Toběrný M, Černohorský S, Fidler F, Poněšický J, Tobiáš J, Beňo P, Blažej S, Valdman J, Košík J, Bartůněk M. DaVinci robotická radikální prostatektomie – naše současná technika a výsledky. Endoskopie 2009; 18(1): 28–36.
25. Boorjian SA, Eastham JA, Graefen M, Guillonneau B, Karnes RJ, Moul JW, Schaeffer EM, Stief C, Zorn KC. A critical analysis of the long-term impact of radical prostatectomy on cancer control and function outcomes. Eur Urol 2011, Dec 7. doi:10.1016/j.eururo.2011.11.053
26. Kilminster S, Müller S, Menon M, Joseph JV, Ralph DJ, Patel HR. Predicting erectile function outcome in men after radical prostatectomy for prostate cancer. BJU Int. 2011, Dec 19. doi: 10.1111/j.1464-410X.2011.10757.x.
27. Herrell SD, Galloway RL, Su LM. Image-guided robotic surgery: update on research and potential applications in urologic surgery. Curr Opin Urol 2012; 22(1): 47–54.
28. Montorsi F, Wilson TG, Rosen RC, Ahlering TE, Artibani W, Carroll PR, Costello A, Eastham JA, Ficarra V, Guazzoni G, Menon M, Novara G, Patel VR, Stolzenburg JU, Van der Poel H, Van Poppel H, Mottrie A. Best Practices in Robot-assisted Radical Prostatectomy: Recommendations of the Pasadena Consensus Panel. Eur Urol 2012; 62(3): 368–381.
Labels
Paediatric urologist Nephrology UrologyArticle was published in
Czech Urology
2012 Issue 4
Most read in this issue
- Myoglobinuria as a manifestation of rhabdomyolysis following extreme physical exertion
- Nuclear medicine imaging of prostate cancer
- Treatment outcomes of BCG vaccine in patients with T1G3 urothelial cancer – a retrospective analysis
- Retroperitonal liposarcoma in the area of the lower pole of the kidney