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[Laparoscopic adenomectomy versus open adenomectomy: A comparative study.]

Miguel Ángel Bergero1, Juan Manuel Álvarez2, Juan Cruz Liyo3

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|May 8, 2020
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Summary

Laparoscopic adenomectomy (LA) offers comparable functional outcomes to open adenomectomy (OA) for large prostate adenomas. LA demonstrates reduced operative bleeding and shorter hospital stays, making it a viable alternative.

Keywords:
Cirugía laparoscópicaEnfermedad de la próstataHiperplasia de próstataLaparoscopyProstatic DiseasesProstatic Hyperplasia

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Advancements in laparoscopic urological surgery enable its application for voluminous prostatic adenomas.
  • Laparoscopic adenomectomy (LA) is an emerging technique for treating benign prostatic hyperplasia (BPH).

Purpose of the Study:

  • To evaluate and compare the outcomes of laparoscopic adenomectomy (LA) versus open adenomectomy (OA).
  • To assess the efficacy and safety of LA for large prostate adenomas (>100 grams).

Main Methods:

  • A prospective comparative study involving 41 patients undergoing LA and 44 patients undergoing OA for prostate adenomas exceeding 100 grams.
  • Data collection included preoperative, intraoperative, and postoperative parameters, as well as complication rates.
  • LA techniques included Millin (LA-MT) and transvesical (LA-TV) approaches.

Main Results:

  • Both LA and OA demonstrated similar surgical times and postoperative functional outcomes (IPSS, Qmax).
  • Laparoscopic adenomectomy (LA) resulted in significantly less operative bleeding (100ml vs 500ml) and shorter hospital stays (3 days vs 3.5 days) compared to open adenomectomy (OA).
  • No significant differences were observed in transfusion requirements or complication rates between the two surgical approaches.

Conclusions:

  • Laparoscopic adenomectomy (LA) provides comparable short-term functional results to open adenomectomy (OA) for large prostate adenomas.
  • LA is associated with reduced operative bleeding and shorter hospitalization, indicating potential advantages.
  • LA is a safe and effective alternative to OA for managing voluminous prostatic adenomas.