Evolution of endoscopic extraperitoneal radical prostatectomy (EERPE)?technical improvements and development of a nerve-sparing, potency-preserving approach

Stolzenburg, Jens‐Uwe; Truß, Michael C.; Do, Minh; Robert, René; Pfeiffer, H.; Dunzinger, Michael; Aedtner, Bernd; Stief, Christian G.; Jonas, Udo; Dorschner, Wolfgang

doi:10.1007/s00345-003-0351-2

Cited by 76 publications

(33 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It reduces the risks of damaging intraperitoneal organs, prolonged adynamic ileus, intracavitary tumor spread, as well as bleeding or urine extravasations into the peritoneal cavity. Some authors also believe that it allows better dissection of the neurovascular, as demonstrated in other series (14,15).…”

Section: Commentsmentioning

confidence: 89%

Preliminary experience with extraperitoneal endoscopic radical prostatectomy through duplication of the open technique

Tobias-Machado¹,

Lasmar²,

Medina³

et al. 2005

Int. braz j urol.

View full text Add to dashboard Cite

Objective: To describe surgical and functional results with extraperitoneal laparoscopic radical prostatectomy with duplication of the open technique, from the experience obtained in the treatment of 28 initial cases.Materials and Methods: In a 36-month period, we prospectively analyzed 28 patients diagnosed with localized prostate cancer undergoing extraperitoneal laparoscopic radical prostatectomy.Results: Mean surgical time was 280 min, with mean blood loss of 320 mL. As intraoperative complications, there were 2 rectal lesions repaired with laparoscopic suture in 2 planes. There was no conversion to open surgery. Median hospital stay was 3 days, with return to oral diet in the first postoperative day in patients. As post-operative complications, there were 3 cases of extraperitoneal urinary fistula. Two of these cases were resolved by maintaining a Foley catheter for 21 days, and the other one by late endoscopic reintervention for repositioning the catheter. Five out of 18 previously potent patients evolved with erectile dysfunction. The diagnosis of prostate cancer was confirmed in all patients, with focal positive margin occurring in 3 cases. During a mean follow-up of 18 months, 2 patients presented increased PSA, with no clinical evidence of disease.Conclusion: Laparoscopic radical prostatectomy is a laborious and difficult procedure, with a long learning curve. Extraperitoneal access is feasible, and it is possible to practically duplicate the principles of open surgery. The present technique can possibly offer advantages in terms of decreased blood loss, preservation of erectile function and prevention of positive margins.

show abstract

Section: Commentsmentioning

confidence: 89%

Preliminary experience with extraperitoneal endoscopic radical prostatectomy through duplication of the open technique

Tobias-Machado¹,

Lasmar²,

Medina³

et al. 2005

Int. braz j urol.

View full text Add to dashboard Cite

show abstract

“…Ya se ha descrito previamente la técnica inicial de PRETE [9][10][11] . Al aumentar nuestra experiencia en la realización de PRETE, pudimos desarrollar un planteamiento de conservación de nervios (PRETEcn) que aplicamos de forma habitual en pacientes seleccionados.…”

Section: La Técnicaunclassified

“…En 2003, publicamos los resultados obtenidos en los 70 primeros casos 10 . Desde entonces, hemos mejorado la técnica de forma continua, incluyendo la conservación de nervios para mantener la potencia sexual (PRETEcn) 11 . En este trabajo, presentamos la evolución de la téc-nica y los últimos resultados oncológicos y funcionales después de 700 procedimientos.…”

unclassified

Prostatectomía radical extraperitoneal laparoscópica: evolución en el tiempo y resultados actualizados

Stolzenburg

Rabenalt

et al. 2006

Actas Urol Esp

View full text Add to dashboard Cite

RESUMEN PROSTATECTOMÍA RADICAL EXTRAPERITONEAL LAPAROSCÓPICA: EVOLUCIÓN EN EL TIEMPOY RESULTADOS ACTUALIZADOS La prostatectomía radical laparoscópica ha sido establecida y adoptada por centros urológicos especializados de todo el mundo como el método fundamental de tratamiento quirúrgico del cáncer de próstata localizado. Los urólogos mantienen una búsqueda constante de desarrollo de modificaciones y refinamientos técnicos, para reducir la morbilidad y mejorar el resultado clínico y de calidad de vida.En 2002, comunicamos inicialmente nuestra técnica y experiencia con la prostatectomía radical endoscópica totalmente extraperitoneal (PRETE). En este artículo de revisión presentamos la evolución de la técnica y los últimos resultados.Palabras clave: Prostatectomía radical extraperitoneal. Técnica. Laparoscopia. Cáncer de próstata. ABSTRACT LAPAROSCOPIC EXTRAPERITONEAL RADICAL PROSTATECTOMY: EVOLUTION IN TIMEAND UPDATED RESULTS Laparoscopic radical prostatectomy has been established and adopted by specialized urologic centers around the world as the primary approach to the surgical management of localized prostate cancer. Urologists are on a continuous search for development of technical modifications and refinements, to reduce morbidity and ameliorate clinical and quality of life outcome.In 2002 we have initially reported our technique and experience with the totally extraperitoneal endoscopic radical prostatectomy (EERPE). In the present review paper we present the evolution of the technique and the latest results.

show abstract

“…Die Technik der EERPE wurde kontinuierlich weiterentwickelt, einschließ-lich der Entwicklung einer nerven-und potenzerhaltenden Operationstechnik (nEERPE). Sie wird mittlerweile standardisiert und als First-line-Therapie des lokal begrenzten Prostatakarzinoms eingesetzt [24,25].…”

Section: Präperitonealraumesunclassified

Die endoskopische extraperitoneale radikale Prostatektomie (EERPE)

et al. 2004

View full text Add to dashboard Cite

During the last decade laparoscopy has become the standard technique in the urologist's armamentarium due to constant technological advancements and refinements. Laparoscopic radical prostatectomy (LRPE), although technically demanding and associated with a considerable learning curve, has become the operative procedure of choice for patients with clinically localized prostate cancer in selected and specialized urologic centers around the globe. However, a major drawback of LRPE is the transperitoneal route of access to the extraperitoneal organ of the prostate. The principal disadvantages of LRPE are potential intraperitoneal complications. Endoscopic extraperitoneal radical prostatectomy (EERPE) is a further advancement of minimally invasive surgery as it overcomes the limitations of LRPE by the strictly extraperitoneal route of access. Based on our growing experience with this procedure we introduce several technical modifications, improvements, and refinements including a nerve-sparing, potency-preserving approach (nEERPE) in an effort to further improve this minimally invasive procedure. We report our short-term follow-up results after 300 procedures. The mean operative times were 115 min without and 150 min with lymph node dissection, in total 140 min (range: 60-260 min). There was no conversion and the transfusion rate was 1.3%. There were three early reinterventions (two bleeding and one hematoma) and five late reinterventions (four symptomatic lymphoceles and one colostomy due to a rectal fistula). Pathological stage was pT2a in 54 patients (18%), pT2b in 87 patients (29%), pT3a in 115 patients (38.3%), pT3b in 40 patients (13.3%), and pT4 in 4 patients (1.3%). Positive surgical margins were found in 9.2% (13/141) of patients with pT2 tumor and 30.3% (47/155) of patients with pT3 tumor. The mean catheterization time was 6.9 days. Six and twelve months postoperatively 86.3 and 89.6% of the patients were completely continent; 9.2% of patients needed 1-2 pads per day and 4.5 and 1.2% of patients needed more than 2 pads per day, respectively. Short-term oncological and functional results of EERPE are at least as favorable as in LRPE while operative times are shorter and complication rates are low. EERPE is a technical advancement because it combines the advantages of a totally extraperitoneal access with the advantages of a minimally invasive procedure.

show abstract

Evolution of endoscopic extraperitoneal radical prostatectomy (EERPE)?technical improvements and development of a nerve-sparing, potency-preserving approach

Cited by 76 publications

References 17 publications

Preliminary experience with extraperitoneal endoscopic radical prostatectomy through duplication of the open technique

Preliminary experience with extraperitoneal endoscopic radical prostatectomy through duplication of the open technique

Prostatectomía radical extraperitoneal laparoscópica: evolución en el tiempo y resultados actualizados

Die endoskopische extraperitoneale radikale Prostatektomie (EERPE)

Contact Info

Product

Resources

About