Complications, Urinary Continence, and Oncologic Outcomes of Laparoscopic Radical Prostatectomy: Single-Surgeon Experience for the First 100 Cases

Abstract

Objective. The aim of the present study was to evaluate initial learning curves of laparoscopic radical prostatectomy (LRP) with regard to complications, urinary continence, and oncologic outcome. Materials and Methods. We retrospectively reviewed 100 consecutive patients with clinically localized prostate cancer. All 100 patients underwent LRP performed by the same urologist at one institution. Results: Mean operating time (208.4 ± 48.6 min), estimated blood loss (495.8 ± 436.5 mL), allogeneic blood transfusion rate (0%), and intraoperative complications diminished with surgical experience. Positive margin rate varied greatly among pathological stage (positive margin rates: pT2 = 20.5%; pT3 = 63.0%). A trend towards reduction of positive surgical margins in pT2 cases was apparent with increasing experience. Intraoperative and early complications occurred in 2.0% of patients. In all patients, 85.9% used none or no more than one pad per 24 h at 6 months postoperatively. Prostate-specific antigen recurrence was seen in only 2 patients. Conclusions. In the present series of 100 patients, our retrospective evaluation confirms that LRP provides satisfactory results.

Prostate cancer in East Asia: evolving trend over the last decade

“…We reviewed the current literatures 117 118 119 120 121 122 123 124 125 126 127 128 129 and compared perioperative parameters and the trifecta outcomes (cancer control, continence, and potency) following RP among Asians and Westerners ( Table 3 ). As the improvement of the technical expertise and the migration toward low-risk disease in recent years, the perioperative complication rate and oncological outcomes has been comparable in the series from East Asia and Western countries.…”

Comparative Cost-effectiveness of Robot-assisted and Standard Laparoscopic Prostatectomy as Alternatives to Open Radical Prostatectomy for Treatment of Men with Localised Prostate Cancer: A Health Technology Assessment from the Perspective of the UK National Health Service

“…The high cost has led a number of authorities to question the value of robotic technology to patients and health care systems [7]. Consequently the standard laparoscopic technique continues to be practised in a number of centres [6,8]; for example in the United Kingdom (UK) in 2012, of 5464 radical prostatectomies performed 2467 (45%) were open, 1393 (26%) standard laparoscopic and 1604 (29%) robot-assisted [9], whereas in the United States the proportions were open 44%, laparoscopic 3% and robotic 53% [10]. None of the many simple cost comparisons of different radical prostatectomy techniques have included cost-effectiveness analysis taking into account the value of relative health gains that men may achieve if a particular technique has better outcomes [7].…”

A Novel “Three-port” Trocar Placement Technique for Laparoscopic Radical Prostatectomy

“…In developing countries such as China, choosing LRP instead of RARP remains common due to the robotic medical expenses that the national health insurance system does not cover. Factually, the standard laparoscopic technique still continues to be practiced in a number of centers in developed countries due to the higher total hospitalization costs of RARP [17,18] .…”