Alternativa para a ligadura do complexo da veia dorsal na prostatectomia radical retro-púbica / Alternative for ligation of dorsal vein complex in radical retropubic prostatectomy

RESUMO

Radical prostatectomy is regarded as a standard surgical treatment of cancer confined to the prostate and has withstood the test of time. Early ligature of the dorsal vein complex reduces significantly operative blood loss and several surgical instruments were developed to perform this procedure. In our department, such an instrument was introduced in 1995 through a subtle modification of an original Babcock's clamp, allowing a simple and unique ligature by uniting the whole network of dorsal veins. From september 1995 to november 1998, 126 prostatectomies were carried out with this technique. The mean operative time was 2 hours and 36 minutes and the mean blood loss was 450 ml during radical prostatectomy and selective pelvic lymphadenectomy. We conclude that early single ligature of the dorsal vein network reduces significantly the risk of operative hemorrhage during radical prostatectomy, although the problem deserves a randomizes and controlled approach: