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Endourological Management of Urogenital Carcinoma pp 147–159Cite as

Laparoscopic Radical Prostatectomy: Oncological and Functional Results

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Part of the book series: Recent Advances in Endourology ((ENDOUROLOGY,volume 7))

Summary

Between December 1999 and December 2004, 160 patients with organ-confined prostate cancer underwent laparoscopic radical prostatectomy (LRP) by two surgeons with many different assistants. The patients were divided into two groups in order of the date of surgery. Groups I and II consisted of 66 and 94 patients who were operated on between December 1999 and March 2002 and between April 2002 and December 2004, respectively. Group I was subdivided into Group I-a and Group I-b: Group I-a consisted of 36 patients who underwent LRP at Tenri Hospital and Group I-b consisted of 30 patients who underwent LRP at the other institutions in the same period. The patients in Group I-b were evaluated only for operative morbidity and excluded from analysis of oncological outcome because of insufficient pathological data. Mean operative time and mean blood loss including leaked urine in Group II were 291 ± 57.2min (range 145–425min) and 401.0 ± 323.7 g (range 14–1859 g). There was no blood transfusion in Group II and no operative conversion to an open retropubic radical prostatectomy (RRP). Mean postoperative urethral catheter indwelling period and mean postoperative hospital stay were 4 ± 4.8 days (range 3–28) and 8 ± 4.5 days (range 4–25) in Group II, respectively. Positive surgical margin was detected in 18/130 cases (13.8%) for all pathological stages in this series, but 7/105 cases (6.6%) with pT2 and pT0 disease. Positive surgical margin was detected at the apical margin most frequently. To achieve earlier recovery of urinary continence, a ligation of the dorsal vein complex (DVC bunching) was decided against and substituted by closure of DVC stump with a vertical running suture for hemostasis. In the latter group in Group II, 55% and 87% of the patients were almost dry at 1 and 3 months postoperatively, respectively. Eight of 31 patients (25.8%) who had preserved unilateral neurovascular bundle (NVB) regained potency to be able to carry out sexual intercourse between 6 and 15 months postoperatively. Less morbidity, encouraging early oncological results and improved early recovery of urinary continence, are favorable factors for LRP; however, long-term follow-up and consecutive effort to improve the apical section procedure are required for establishment of LRP as a reliable treatment tool for organ-confined prostate cancer.

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Authors and Affiliations

  1. Department of Urology, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa, 259-1193, Japan

    Toshiro Terachi, Yukio Usui & Masanori Shima

  2. Department of Urology, Tenri Hospital, Tenri, Nara, 632-0015, Japan

    Kazuhiro Okumura

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  1. Toshiro Terachi
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  2. Yukio Usui
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  3. Masanori Shima
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  4. Kazuhiro Okumura
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Editor information

Editors and Affiliations

  1. Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Seiji Naito M.D., Ph.D. (Professor and Chairman) (Professor and Chairman)

  2. Department of Urology, Nara Medical University, 840 Shijyocho, Kashihara, Nara, 634-8522, Japan

    Yoshihiko Hirao M.D., Ph.D. (Professor and Chairman) (Professor and Chairman)

  3. Surgical Science Urology, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa, 259-1193, Japan

    Toshiro Terachi M.D., Ph.D. (Professor and Chairman) (Professor and Chairman)

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© 2006 The Japanese Society of Endourology and ESWL

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Terachi, T., Usui, Y., Shima, M., Okumura, K. (2006). Laparoscopic Radical Prostatectomy: Oncological and Functional Results. In: Naito, S., Hirao, Y., Terachi, T. (eds) Endourological Management of Urogenital Carcinoma. Recent Advances in Endourology, vol 7. Springer, Tokyo. https://doi.org/10.1007/4-431-27786-2_10

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  • DOI: https://doi.org/10.1007/4-431-27786-2_10

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-27785-9

  • Online ISBN: 978-4-431-27786-6

  • eBook Packages: MedicineMedicine (R0)

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