Oncological and functional results of extraperitoneal laparoscopic radical prostatectomy

Zheng,Tao; Zhang,Xu; Ma,Xin; Li,Hong-Zhao; Gao,Jiang-Pin; Cai,Wei; Chen,Guang-Fu; Dong,Jun; Wang,Bao-Jun; Shi,Tao-Ping

doi:10.3892/ol.2012.737

August 2012 Volume 4 Issue 2

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August 2012 Volume 4 Issue 2

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Article

Oncological and functional results of extraperitoneal laparoscopic radical prostatectomy

Authors:
- Tao Zheng
- Xu Zhang
- Xin Ma
- Hong-Zhao Li
- Jiang-Pin Gao
- Wei Cai
- Guang-Fu Chen
- Jun Dong
- Bao-Jun Wang
- Tao-Ping Shi
View Affiliations / Copyright

Affiliations: Department of Urology, Chinese People's Liberation Army General Hospital, Military Postgraduate Medical College, Haidian, Beijing 100853, P.R. China
Pages: 351-357
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Published online on: May 30, 2012

https://doi.org/10.3892/ol.2012.737
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Abstract

The oncological and functional results of 329 cases in a population treated with extraperitoneal laparoscopic radical prostatectomy (ELRP) were evaluated retrospectively. A total of 329 inconsecutive patients with prostate cancer (PCa) who underwent ELRP were retrospectively analyzed. The median initial prostate-specific antigen (PSA) level was 17.35 ng/ml. The median biopsy Gleason score was 7.77. Patients with a T2 or T3a clinical stage had received preoperative neoadjuvant hormonal therapy (NHT) for 3 to 9 months prior to ELRP. No conversion or re-intervention were observed. The median time for anastomosis, surgery time and postoperative catheterization time were 13.0 min, 90.0 min and 6 days, respectively. The median estimated blood loss was 75 ml. There were 12 temporary urinary leakages requiring prolonged catheterization to 14 days. There was 1 case of deep vein thrombosis, 1 case of alimentary tract hemorrhage and 7 cases of anterior urethral stricture. The median follow-up time was 27 months. A total of 17 patients were lost during the follow-up period. No rectal injury, lymphocele, incision hernia, postoperative persistent urinary leak or anastomotic stricture occurred. Younger patients (≤67 years of age) had a more rapid recovery of continence and a better postoperative potency. The overall positive surgical margin rate was 16.7%, which correlated with the pathological stage and Gleason score, respectively (both P<0.001). A total of 89 (28.6%) patients were diagnosed with biochemical recurrence. The initial PSA value, PSM, pathological stage and Gleason score were identified as independent prognostic factors for biochemical recurrence-free survival using multivariate analysis. Our results demonstrated that preoperative NHT had significant effects on the pathological Gleason score (P<0.001) and surgical margin (P=0.027), but no significant impact on biochemical recurrence (P=0.202). The reproducibility of ELRP has been proven as a reliable curative treatment in Western countries during the last 15 years. Due to the increase in PCa patients, the results of our study may aid surgeons who use ELRP for the first time.

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1	Jemal A, Bray F, Center MM, Ferlay J, Ward E and Forman D: Global cancer statistics. CA Cancer J Clin. 61:69–90. 2011. View Article : Google Scholar
2	Gu FL: The incidences of benign prostatic hyperplasia and prostatic cancer in China. Zhonghua Wai Ke Za Zhi. 31:323–326. 1993.PubMed/NCBI
3	Gu F: Epidemiological survey of benign prostatic hyperplasia and prostatic cancer in China. Chin Med J (Engl). 113:299–302. 2000.PubMed/NCBI
4	Zhang X, Ju Z, Wang C, et al: The single needle method for urethrovesical anastomosis with strengthened posterior fixation during laparoscopic radical prostatectomy. J Huazhong Univ Sci Technolog Med Sci. 29:745–749. 2009. View Article : Google Scholar
5	Stolzenburg JU, Do M, Pfeiffer H, König F, Aedtner B and Dorschner W: The endoscopic extraperitoneal radical prostatectomy (EERPE): technique and initial experience. World J Urol. 20:48–55. 2002. View Article : Google Scholar : PubMed/NCBI
6	Schuessler WW, Schulam PG, Clayman RV and Kavoussi LR: Laparoscopic radical prostatectomy: initial short-term experience. Urology. 50:854–857. 1997. View Article : Google Scholar : PubMed/NCBI
7	Raboy A, Ferzli G and Albert P: Initial experience with extraperitoneal endoscopic radical retropubic prostatectomy. Urology. 50:849–853. 1997. View Article : Google Scholar : PubMed/NCBI
8	Van Velthoven RF, Ahlering TE, Peltier A, Skarecky DW and Clayman RV: Technique for laparoscopic running urethrovesical anastomosis: the single knot method. Urology. 61:699–702. 2003.PubMed/NCBI
9	Rozet F, Galiano M, Cathelineau X, Barret E, Cathala N and Vallancien G: Extraperitoneal laparoscopic radical prostatectomy: a prospective evaluation of 600 cases. J Urol. 174:908–911. 2005. View Article : Google Scholar : PubMed/NCBI
10	Stolzenburg JU, Kallidonis P, Minh D, et al: Endoscopic extraperitoneal radical prostatectomy: evolution of the technique and experience with 2400 cases. J Endourol. 23:1467–1472. 2009. View Article : Google Scholar : PubMed/NCBI
11	Eden CG, Neill MG and Louie-Johnsun MW: The first 1000 cases of laparoscopic radical prostatectomy in the UK: evidence of multiple ‘learning curves’. BJU Int. 103:1224–1230. 2009.PubMed/NCBI
12	Do M, Haefner T, Liatsikos E, et al: Endoscopic extraperitoneal radical prostatectomy after previous transurethral resection of prostate: oncologic and functional outcomes of 100 cases. Urology. 75:1348–1352. 2010. View Article : Google Scholar
13	Hu JC, Elkin EP, Pasta DJ, Lubeck DP, Kattan MW, Carroll PR and Litwin MS: Predicting quality of life after radical prostatectomy: results from CaPSURE. J Urol. 171:703–707. 2004. View Article : Google Scholar : PubMed/NCBI
14	Mendiola FP, Zorn KC, Mikhail AA, Lin S, Orvieto MA, Zagaja GP and Shalhav AL: Urinary and sexual function outcomes among different age groups after robot-assisted laparoscopic prostatectomy. J Endourol. 22:519–524. 2008. View Article : Google Scholar

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Oncological and functional results of extraperitoneal laparoscopic radical prostatectomy

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Abstract

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