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Endoscopic extraperitoneal radical prostatectomy and its complications – own experience from the first 300 procedures


Authors: Květoslav Novák 1;  Petr Macek 1;  Michael Vraný 2;  Michael Pešl 1;  Zuzana Vaľová 1;  Jan Dvořáček 1;  Tomáš Hanuš 1
Authors‘ workplace: Urologická klinika 1. LF UK a VFN, Praha 1;  Chirurgické oddělení Nemocnice Jablonec nad Nisou 2
Published in: Ces Urol 2014; 18(2): 119-127
Category: Original article

Overview

Goal of study:
The goal of the study was to evaluate complications in a group of patients with prostate carcinoma (PC) surgically treated by endoscopic extraperitoneal radical prostatectomy (EERP) at our department.

Method:
We performed this type of surgery exclusively using the extraperitoneal approach as an anterograde procedure. Five chronologically arranged groups of patients were compared (A-36, B-34, C-70, D-77, E-83).

Results:
From 2/2008 to 6/2013 we performed 300 EERP in patients with a BMI up to 45, age 48–77 (ø 64) years, PSA 0.71–34.9 (ø 8,1) ng/ml. Specimen weight was 15–185 (ø 56) g. Average duration of the procedure in individual groups were: A – 265 min, B – 220 min, C – 200 min, D – 142 min, E – 129 min, blood loss > 1000 ml was seen in 19 (53%) patients in group A, 6 (18%) in B, 3 (4%) in C, 6 (8%) in D in, and 2 (3%) in E, blood substitution was need in only 9 (3%) patients. None of the procedures were converted to open, surgical revision for bleeding the same day was indicated in 2 (0.7%). Rectal injuries occurred in 6 (2%) procedures. These were recognized immediately and sutured in 4 (all healed), vesicorectal fistula developed in 2 (both healed after late reconstruction). Other major complications were published.

Conclusion:
EERP is a minimally invasive surgical procedure recommended in patients with localized PC. Perioperative outcomes improved as the number of procedures increased. Frequency of complications was low.

Key words:
endoscopic extraperitoneal radical prostatectomy, complications.


Sources

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Paediatric urologist Nephrology Urology
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