<b>Aim:</b> The purpose of this study to present the upgrading method of laparoscopic procedure of prostate cancer.<br /> <b>Material and methods:</b> This work was made as part of the PhD dissertation. This technique could be recommended for treatment of the prostate gland tumors. The Patent of the Republic of Kazakhstan №35437 was received on 31.12.2021&nbsp; &nbsp;<br /> <b>Results</b>: The laparoscopic procedure for both methods are the same, there is some upgrading of traditional method by proposing improvements of trocars insertion. During traditional method four working trocars are installed extraperitoneal under the control of optics. We recommend four working trocars are installed under the control of the index finger, palpating the lower epigastric vessels from the inside; it is avoid to damage of the peritoneum, injection of gas into the abdominal space, damage of the vessels of the pelvis.<br /> <b>Conclusion:</b> The method allows avoiding bleeding, pneumoperitoneum, and decreased saturation; and in the early postoperative period, peritonitis is excluded and the late postoperative period, adhesive processes do not occur.

Relevance: From 2010 to 2019, prostate cancer morbidity increased, and prostate cancer mortality decreased in Kazakhstan. The peak incidence was observed in patients aged 70 years and older. The East Kazakhstan region had higher morbidity and mortality from prostate cancer than the national average. The study aimed to assess the indicators of prostate cancer epidemiology in the East Kazakhstan region from 2010 to 2019. Methods: The study calculated prostate cancer incidence, mortality, one-year and five-year survival, and early detection from 2010 to 2019. The statistical significance was assessed by the one-factor linear regression method. Intensive epidemiological indicators were calculated per 100 000 male population. Results: The prostate cancer incidence in East Kazakhstan increased from 2010 to 2019, while the mortality rate increased slightly. There was a statistically significant upward trend for morbidity (p=0.009) and a statistically insignificant trend for mortality (p=0.900). The one-year survival with prostate cancer tended to decrease. However, the trend of one-year survival rates had no statistical significance (p=0.202). The five-year survival rate of patients with prostate cancer in the East Kazakhstan region during the study period tended to decrease. However, the trend in the five-year survival rates of patients with prostate cancer in the East Kazakhstan region had no statistical significance (p=0.826). Early detection of prostate cancer in the early stages remained sustainable in the range of 72.7-77.4. In 2019, this indicator decreased to 63.2%. The share of prostate cancer cases detected at stage III tended to increase. The proportion of prostate cancer cases detected at stage IV tended to decrease during the study period. Conclusion: The prostate cancer epidemiological rates in East Kazakhstan were unstable in the study period. The incidence tended to increase; the mortality rate fluctuated within small limits and remained sustainable. The one-year survival rate tended to decrease. The five-year survival rate was slightly increasing. There was an increase in the detection of prostate cancer at stage III, while the detection at stage IV tended to decrease. Early detection of prostate cancer has decreased with an increase in detection at stage III. The proportion of prostate cancer cases detected at stage IV in the study period tended to decrease.

Relevance: From 2010 to 2019, prostate cancer morbidity increased, and prostate cancer mortality decreased in Kazakhstan. The peak incidence was observed in patients aged 70 years and older. The East Kazakhstan region had higher morbidity and mortality from prostate cancer than the national average. The study aimed to: assess the indicators of prostate cancer epidemiology in the East Kazakhstan region from 2010 to 2019. Methods: The study calculated prostate cancer incidence, mortality, one-year and five-year survival, and early detection from 2010 to 2019. The statistical significance was assessed by the one-factor linear regression method. Intensive epidemiological indicators were calculated per 100 000 male population. Results: The prostate cancer incidence in East Kazakhstan increased from 2010 to 2019, while the mortality rate increased slightly. There was a statistically significant upward trend for morbidity (p=0.009) and a statistically insignificant trend for mortality (p=0.900). The one-year survival with prostate cancer tended to decrease. However, the trend of one-year survival rates had no statistical significance (p=0.202). The five-year survival rate of patients with prostate cancer in the East Kazakhstan region during the study period tended to decrease. However, the trend in the five-year survival rates of patients with prostate cancer in the East Kazakhstan region had no statistical significance (p=0.826). Early detection of prostate cancer in the early stages remained sustainable in the range of 72.7-77.4. In 2019, this indicator decreased to 63.2%. The share of prostate cancer cases detected at stage III tended to increase. The proportion of prostate cancer cases detected at stage IV tended to decrease during the study period. Conclusion: The prostate cancer epidemiological rates in East Kazakhstan were unstable in the study period. The incidence tended to increase; the mortality rate fluctuated within small limits and remained sustainable. The one-year survival rate tended to decrease. The five-year survival rate was slightly increasing. There was an increase in the detection of prostate cancer at stage III, while the detection at stage IV tended to decrease. Early detection of prostate cancer has decreased with an increase in detection at stage III. The proportion of prostate cancer cases detected at stage IV in the study period tended to decrease.

Relevance: Laparoscopic surgery supplies many benefits due to lower postoperative sequelae. Laparoscopic radical prostatectomy has become a first-line treatment for patients with localized prostate cancer worldwide. The study aimed to compare outcomes after traditional laparoscopic extraperitoneal radical prostatectomy with modified laparoscopic extraperitoneal radical prostatectomy (MLERPE). Methods: All information about patient treatment for this historical cohort study was obtained from the “Electronic In-patient Registry” of the Republic of Kazakhstan. The study included case records of 94 patients who underwent laparoscopic extraperitoneal radical prostatectomy from 2017 to 2021. Of them, 45 underwent a modified laparoscopic prostatectomy, and 49 – a traditional laparoscopic prostatectomy. Data are presented as the means ± standard deviation or as frequencies and percentages. Pearson’s Chi-square was used for qualitative data. T-test and Mann-Whitney U test were used to compare the means of the two groups. The statistical significance level was 0.05. Results: We revealed significant differences between the laboratory parameters of both groups after surgery. The mean difference in hemoglobin level between the two groups was 14.04, the mean difference in erythrocyte level was 0.69, the mean difference in leukocyte level was 1.26, and the mean difference in ESR level was 2.01. All differences were statistically significant (p=0.000). We found a statistical difference in the duration of operation and hospital stay between the two groups (p=0.000). Conclusion: The modified laparoscopic technique avoids adverse worse outcomes such as bleeding, pneumoperitoneum, and decreasing oxygen saturation. This technique is also beneficial in the early postoperative period for excluding peritonitis, and the late postoperative period avoids adhesive processes.

Relevance: Laparoscopic surgery supplies many benefits due to lower postoperative sequelae. Laparoscopic radical prostatectomy has become a first-line treatment for patients with localized prostate cancer worldwide. The study aimed to compare outcomes after traditional laparoscopic extraperitoneal radical prostatectomy with modified laparoscopic extraperitoneal radical prostatectomy (MLERPE). Methods: All information about patient treatment for this historical cohort study was obtained from the “Electronic In-patient Registry” of the Republic of Kazakhstan. The study included case records of 94 patients who underwent laparoscopic extraperitoneal radical prostatectomy from 2017 to 2021. Of them, 45 underwent a modified laparoscopic prostatectomy, and 49 – a traditional laparoscopic prostatectomy. Data are presented as the means ± standard deviation or as frequencies and percentages. Pearson’s Chi-square was used for qualitative data. T-test and Mann-Whitney U test were used to compare the means of the two groups. The statistical significance level was 0.05. Results: We revealed significant differences between the laboratory parameters of both groups after surgery. The mean difference in hemoglobin level between the two groups was 14.04, the mean difference in erythrocyte level was 0.69, the mean difference in leukocyte level was 1.26, and the mean difference in ESR level was 2.01. All differences were statistically significant (p=0.000). We found a statistical difference in the duration of operation and hospital stay between the two groups (p=0.000). Conclusion: The modified laparoscopic technique avoids adverse worse outcomes such as bleeding, pneumoperitoneum, and decreasing oxygen saturation. This technique is also beneficial in the early postoperative period for excluding peritonitis, and the late postoperative period avoids adhesive processes.