[Laparoscopic radical prostatectomy: initial experience: about two cases]

ABSTRACT

Laparoscopic radical prostatectomy was a major breakthrough in the treatment of localized prostate cancer. To report the first two laparoscopic radical prostatectomies performed in Tunisia. The two patients are aged 57 and 66 and were suffering from localized prostate cancer. We first tested the transperitoneal and under-peritoneal paths. We then used an anterogradic surgery technique with preservation of the bladder-neck, extra-facial dissection of neuro-vascular bandles and vesicourethral running anastomosis. The two procedures lasted 435 and 305 minutes. We did not have any conversion nor blood transfusion. Post-operatory situation was simple. The two patients were kept in clinic for 4 days and the trans-urethral catheter was removed 7 days following the surgery. The anatomo-pathologic study finds a negative surgical margins for both patients. 3 months later, both patients are continents. Only one of them showed an erection with phosphodieseterase type 5 inhibitors. The total PSA is indetectable. Laparoscopic radical prostatectomy for localized prostate cancer is a technique that has proven its effectiveness since 10 years at least