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Lower incidence of inguinal hernia: minilaparotomy radical retropubic prostatectomy compared with conventional
Takeo Nomura1, Hiromitsu Mimata, Hirokazu Kitamura
1Department of Oncological Science (Urology), Faculty of Medicine, Oita University, Oita, Japan. take@med.oita-u.ac.jp
Introduction:
The purpose of the present study was to compare the incidence of inguinal hernias after conventional and minilaparotomy (minilap) radical retropubic prostatectomy (RRP).
Patients And Methods:
In this retrospective study, we review our experience with 70 consecutive patients with prostate cancer who underwent prostatectomy from April 1995 through March 2001. Of these, 35 patients had conventional RRP, and 35 patients had minilap RRP.
Results:
Conventional RRP and minilap RRP groups were similar in body mass index (mean 24.4 and 23.5), operative time (mean 260 and 241 min), previous lower abdominal operation record (mean 37.1 and 25.7%), and post-prostatectomy anastomotic strictures (mean 11.4 and 14.3%). The volume of the estimated blood loss was significantly less for minilap RRP (mean 1,220 ml) than for conventional RRP (mean 1,666 ml; p = 0.0194). The incidence of postoperative inguinal hernias was 17.1% (6 of 35), 2.9% (1 of 35), and 3.2% (1 of 31) in conventional RRP, minilap RRP, and unoperated groups, respectively. The incidence of inguinal hernias after minilap RRP was significantly lower than after conventional RRP (p = 0.0464). Seven patients with postoperative inguinal hernias had a high incidence of postoperative strictures (42.9%), while 63 patients without hernia had a low incidence (9.5%). There was a significant difference in developing postoperative strictures between patients with hernia and those without (p = 0.0124). While postoperative stricture and operative technique were different in the hernia and hernia-free groups on univariate analysis, multivariate logistic analysis revealed that the operative technique was an independent factor for the occurrence of inguinal hernias (p = 0.0419).
Conclusion:
Minilap RRP compares favorably with conventional RRP in view of the postoperative inguinal hernia development.
Insights
Minilaparotomy (minilap) radical retropubic prostatectomy (RRP) significantly reduces inguinal hernia incidence compared to conventional RRP. This minimally invasive approach offers a favorable outcome for prostate cancer patients regarding hernia development.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Radical retropubic prostatectomy (RRP) is a standard treatment for prostate cancer.
- Postoperative inguinal hernias are a known complication following RRP.
- Comparing surgical techniques is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare the incidence of inguinal hernias after conventional radical retropubic prostatectomy (RRP) versus minilaparotomy (minilap) RRP.
- To evaluate the impact of surgical approach on postoperative hernia development.
Main Methods:
- Retrospective review of 70 prostate cancer patients undergoing RRP (April 1995-March 2001).
- Comparison between 35 patients with conventional RRP and 35 patients with minilap RRP.
- Analysis of hernia incidence, operative time, blood loss, and anastomotic strictures.
Main Results:
- Minilap RRP showed a significantly lower incidence of inguinal hernias (2.9%) compared to conventional RRP (17.1%).
- Estimated blood loss was significantly lower in the minilap RRP group.
- Operative technique was identified as an independent factor for inguinal hernia occurrence.
Conclusions:
- Minilaparotomy RRP demonstrates a favorable profile regarding postoperative inguinal hernia development.
- The minilap approach may reduce the risk of inguinal hernias following prostatectomy.
- Surgical technique plays a significant role in preventing postoperative inguinal hernias.