Preliminary experience with extraperitoneal endoscopic radical prostatectomy through duplication of the open technique
Int. braz. j. urol
;
31(3): 228-235, May-June 2005. tab
Artículo
en Inglés
| LILACS
| ID: lil-411097
RESUMO
OBJECTIVE:
To describe surgical and functional results with extraperitoneal laparoscopic radical prostatectomy with duplication of the open technique, from the experience obtained in the treatment of 28 initial cases. MATERIALS ANDMETHODS:
In a 36-month period, we prospectively analyzed 28 patients diagnosed with localized prostate cancer undergoing extraperitoneal laparoscopic radical prostatectomy.RESULTS:
Mean surgical time was 280 min, with mean blood loss of 320 mL. As intraoperative complications, there were 2 rectal lesions repaired with laparoscopic suture in 2 planes. There was no conversion to open surgery. Median hospital stay was 3 days, with return to oral diet in the first post-operative day in patients. As post-operative complications, there were 3 cases of extraperitoneal urinary fistula. Two of these cases were resolved by maintaining a Foley catheter for 21 days, and the other one by late endoscopic reintervention for repositioning the catheter. Five out of 18 previously potent patients evolved with erectile dysfunction. The diagnosis of prostate cancer was confirmed in all patients, with focal positive margin occurring in 3 cases. During a mean follow-up of 18 months, 2 patients presented increased PSA, with no clinical evidence of disease.CONCLUSION:
Laparoscopic radical prostatectomy is a laborious and difficult procedure, with a long learning curve. Extraperitoneal access is feasible, and it is possible to practically duplicate the principles of open surgery. The present technique can possibly offer advantages in terms of decreased blood loss, preservation of erectile function and prevention of positive margins.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Prostatectomía
/
Neoplasias de la Próstata
/
Adenocarcinoma
/
Endoscopía
Tipo de estudio:
Estudio de etiología
/
Estudio observacional
/
Estudio pronóstico
Límite:
Anciano
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Int. braz. j. urol
Asunto de la revista:
Urología
Año:
2005
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
ABC Medical School/BR
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