[Rebirth of perineal prostatectomy in the era of laparoscopic lymphadenectomy]

Radical prostatectomy has become the gold standard treatment for localized prostate cancer. With the introduction of Laparoscopy Lymphadenectomy for Staging of Prostate Cancer in 1991, interest in the perineal approach to radical prostatectomy has been renewed. Historically, the perineal approach has proven to be less morbid than the retropubic counterpart. Herein, the authors report their experience with 98 male patients with clinically localized T2B (or less) Cancer of the Prostate who underwent Laparoscopic Lymphadenectomy of which 83, subsequently, had a radical perineal prostatectomy. The mean follow up of this group of patients was 16.5 months. Clinicopathological results are discussed and compared with the results of radical retropubic prostatectomy in the literature.

(1) laparoscopic lymphadenectomy with radical perineal prostatectomy are less morbid, with a faster recovery rate than the standard radical retropubic prostatectomy approach. (2) as better non-surgical methods evolve in predicting the status of the pelvic lymph nodes, reserving laparoscopic lymphadenectomy for patients with high risk of developing lymph nodes' metastasis, the perineal prostatectomy and laparoscopic lymph node dissection are becoming the state of the art treatment in patients with localized prostate cancer.