Extraperitoneal laparoscopic radical prostatectomy. Results after 50 cases

Area of Science:

• Urology
• Minimally Invasive Surgery
• Oncology

Background:

• Initial experience with transperitoneal laparoscopic radical prostatectomy led to the development of a pure extraperitoneal approach.
• The extraperitoneal technique aims to mimic open surgery and avoid transperitoneal complications.

Purpose of the Study:

• To evaluate perioperative and postoperative outcomes of the first 50 cases using a pure extraperitoneal laparoscopic radical prostatectomy approach.
• To compare the efficacy and safety of the extraperitoneal approach against transperitoneal or open surgery.

Main Methods:

• A total of 50 patients underwent pure extraperitoneal laparoscopic radical prostatectomy between September 1999 and September 2000.
• Patients' data including age, preoperative PSA, Gleason score, and clinical stage were recorded.
• Perioperative parameters (blood loss, operative time, transfusion rate) and postoperative results (oncological, continence, potency) were assessed.

Main Results:

• Mean operative time was 317 minutes, mean blood loss 680 cm³, with a 13% transfusion rate.
• Postoperative continence rate reached 85% at 6 months, and potency rates were 43% at 3 months and 67% at 6 months.
• Positive surgical margins were observed in 22% of cases, with two major complications (renal failure and urethrorectal fistula).

Conclusions:

• The extraperitoneal laparoscopic radical prostatectomy demonstrates comparable results to transperitoneal or open surgery.
• This approach is reproducible and potentially reduces the risk of intraperitoneal injury.
• Further long-term follow-up and comparative studies are needed to fully validate these findings.