Preliminary experience with extraperitoneal endoscopic radical prostatectomy through duplication of the open technique
| Autor: | Jimmy A. Medina, Eric Roger Wroclawski, Marco T. Lasmar, Pedro Hermínio Forseto, Roberto Vaz Juliano, Marcos Tobias-Machado |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty Laparoscopic radical prostatectomy Urology medicine.medical_treatment Foley catheter retroperitoneum Adenocarcinoma lcsh:RC870-923 prostatic neoplasms Prostate cancer Erectile Dysfunction Urinary Fistula medicine Humans Prospective Studies endoscopy Prospective cohort study Aged prostatectomy Prostatectomy business.industry Middle Aged lcsh:Diseases of the genitourinary system. Urology medicine.disease Surgery Catheter Treatment Outcome Urinary Incontinence Erectile dysfunction business Follow-Up Studies |
| Zdroj: | International braz j urol v.31 n.3 2005 International Braz J Urol Sociedade Brasileira de Urologia (SBU) instacron:SBU International Brazilian Journal of Urology, Vol 31, Iss 3, Pp 228-235 (2005) International braz j urol, Volume: 31, Issue: 3, Pages: 228-235, Published: JUN 2005 |
| ISSN: | 1677-5538 |
| DOI: | 10.1590/s1677-55382005000300006 |
| Popis: | 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 post-operative 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. |
| Databáze: | OpenAIRE |
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