Laparoscopic Versus Open Simple Prostatectomy: A Comparative Study
| Autor: | Andrew Ballaro, F. Dugardin, H. Baumert, Amir V. Kaisary |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Male
Laparoscopic surgery medicine.medical_specialty Urology medicine.medical_treatment Prostatic Hyperplasia Prostate medicine Humans Prospective Studies Laparoscopy Prospective cohort study Aged Retrospective Studies Prostatectomy medicine.diagnostic_test business.industry Perioperative Surgery Endoscopy medicine.anatomical_structure International Prostate Symptom Score business |
| Zdroj: | Journal of Urology. 175:1691-1694 |
| ISSN: | 1527-3792 0022-5347 |
| DOI: | 10.1016/s0022-5347(05)00986-9 |
| Popis: | Laparoscopic simple prostatectomy has recently been developed to remove large prostatic adenomas causing bladder outflow obstruction. To our knowledge the advantages of the laparoscopic vs the standard open approach to this procedure remain undefined. We compared laparoscopic and open simple prostatectomy.Perioperative data on the first 30 consecutive laparoscopic simple prostatectomies performed by 1 surgeon were collected prospectively and compared with retrospectively collected data on a series of 30 consecutive open simple prostatectomies. A Millin and a transvesical-prostatic technique were used in the laparoscopic group and a transvesical technique was used in the open group.There was no significant difference in prostatic size, patient age or body mass index between the 2 groups. In the laparoscopic group the mean International Prostate Symptom score +/- SD improved from 22.4 +/- 6.9 to 5.7 +/- 3.6 and the urinary flow rate improved from 8.1 +/- 2.5 to 24.6 +/- 12.1 ml per minute (each p0.001). Mean total blood loss (367 +/- 363 vs 643 +/- 647 ml), irrigation time (0.33 +/- 0.7 vs 4 +/- 3.5 days), duration of catheterization (4 +/- 1.7 vs 6.8 +/- 4.7 days) and hospital stay (5.1 +/- 1.8 vs 8 +/- 4.8 days) were significantly less in the laparoscopic group than in the open group. Mean operative time was longer in the laparoscopic group (115 +/- 30 vs 54 +/- 19 minutes). Of the 30 patients in the laparoscopic group 24 did not require bladder irrigation. There was no apparent difference in the incidence or severity of complications. There was no difference in perioperative parameters or functional results between the 2 different laparoscopic techniques.Laparoscopic simple prostatectomy has inherent advantages over the open technique. Further studies are indicated to determine whether this technique should be considered the treatment of choice for prostatic adenomas too large for safe endoscopic resection. |
| Databáze: | OpenAIRE |
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