Korean J Urol.
2003 Jul;44(7):617-623.
Laparoscopic Radical Prostatectomy
- Affiliations
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- 1Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea. tkhwang@catholic.ac.kr
Abstract
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PURPOSE: Our experience of laparoscopic radical prostatectomy, for clinically localized prostate cancer, is reported.
MATERIALS AND METHODS
Between July 2001 and August 2002, laparoscopic radical prostatectomy was performed on 16 patients with clinically organ confined prostate cancer. Their mean age, preoperative PSA and Gleason score for the biopsy specimens were 63.9 years old, 12.2ng/ml and 5.6, respectively. The "Montsouris" operation technique was followed, and an urethrovesical anastomosis performed with 5 to 10 interrupted sutures.
RESULTS
Mean operation time and hospital stay were 347 minutes, ranging from 250 to 500, and 8.3 days, ranging from 3 to 12. Conversion to open surgery was necessary in one case due to difficulty with the urethrovesical anastomosis. Three cases needed a blood transfusion with a mean of 2.3 units. Mean postoperative period of an indwelling Foley catheter was 15.4 days (5-36). The intraoperative complications related to the operation procedures were one epigastric artery injury and two vesicle injuries. There was a positive surgical margin in five cases. The postoperative pathological evaluations comprised of 1 pT0, 5 pT2a, 3 pT2b and 7 pT3a. The PSA value decreased to less than 0.5ng/ml after the laparoscopic radical prostatectomy, with the exception of one case.
CONCLUSIONS
Although the mean operation time was still longer than that of conventional open procedures, an intraoperative magnified vision allows for more precise and safer dissections and a meticulous urethrovesical anastomosis. We believe the operative time will decrease further with more experience. The perioperative morbidity with the laparoscopic radical prostatectomy was low. The continence following a laparoscopic radical prostatectomy was comparable to that after an open radical prostatectomy. These results show that a laparoscopic radical prostatectomy can be an acceptable treatment option for localized prostate cancer.
