[Open versus laparoscopic radical prostatectomy: a French center experience].

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Radical prostatectomy is a primary treatment for localized prostate cancer.
• Open radical prostatectomy (ORP) and laparoscopic radical prostatectomy (LRP) are surgical approaches with distinct peri-operative profiles.

Purpose of the Study:

• To compare peri-operative outcomes between ORP and LRP for clinically localized prostate cancer.
• Evaluate differences in blood loss, operative time, hospitalization, catheterization, complications, and oncological margins.

Main Methods:

• Retrospective analysis of 72 patients undergoing ORP (1998-2003) and 279 patients undergoing LRP (2003-2010).
• Comparison of demographic, peri-operative, and pathological data between the two surgical groups.

Main Results:

• LRP group demonstrated significantly lower operative blood loss (500 mL vs. 1500 mL) and shorter hospitalization (6.3 days vs. 9.0 days) compared to ORP (P<0.001).
• ORP group had shorter operative times (160 min vs. 250 min) and a lower rate of positive surgical margins (7.1% vs. 28.7%) (P=0.001).
• Anastomotic strictures were more frequent after ORP (P<0.001), with no significant difference in catheterization duration.

Conclusions:

• Laparoscopic radical prostatectomy (LRP) is associated with reduced blood loss and shorter hospital stays.
• Open radical prostatectomy (ORP) offers advantages in operative time and achieving lower positive margin rates.
• Choice of surgical approach involves balancing these distinct peri-operative and oncological outcomes.