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A Journal on Nephrology and Urology

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Minerva Urologica e Nefrologica 2003 December;55(4):239-50

language: English

Laparoscopic radical prostatectomy: a review of techniques and results worldwide

Trabulsi E. J., Hassen W. A., Touijer A. K., Saranchuk J. W., Guillonneau B.

Depart­ment of Urol­o­gy, Memo­ri­al ­Sloan-Ket­ter­ing Can­cer Cen­ter, New ­York, NY, USA


Lapar­os­cop­ic rad­i­cal pros­ta­tec­to­my (LRP) is cur­rent­ly per­formed in mul­ti­ple cen­ters ­world-­wide, ­with sev­er­al dif­fer­ent sur­gi­cal approach­es and tech­niques uti­lized. A com­pre­hen­sive ­review of the pub­lished lit­er­a­ture ­worldwide on lapar­os­cop­ic rad­i­cal pros­ta­tec­to­my was per­formed to out­line the evo­lu­tion of ­this tech­nique, and to ­review the pub­lished sur­gi­cal, onco­log­i­cal and func­tion­al ­results. A system­at­ic ­review of ­peer ­reviewed arti­cles con­cern­ing lapar­os­cop­ic rad­i­cal pros­ta­tec­to­my was ­obtained ­using Med­line ­query. LRP is ­being per­formed in mul­ti­ple cen­ters world­wide, ­using a varie­ty of sur­gi­cal approach­es and tech­nol­o­gies. Anal­y­sis of ­perioper­a­tive param­e­ters, includ­ing sur­gi­cal ­blood ­loss, oper­a­tive ­time, com­pli­ca­tions and con­va­les­cence, dem­on­strates a low mor­bid­ity and ­shows a ­clear ­trend in improve­ment ­with ­increased expe­ri­ence. The func­tion­al ­results, as record­ed by post­op­er­a­tive uri­nary and sex­u­al func­tions, ­appear encour­ag­ing. The report­ed pos­i­tive sur­gi­cal mar­gin ­rates ­decrease ­with ­more ­recent ­series. Onco­log­i­cal ­results and can­cer con­trol ­rates as meas­ured by PSA recur­rence and dis­ease-­free inter­vals are dif­fi­cult to ascer­tain in the imma­ture ­series pub­lished to ­date.
LRP has wit­nessed tre­men­dous pop­u­lar­ity and wide­spread imple­men­ta­tion in spe­cial­ized cen­ters world­wide. LRP rep­re­sents a tech­ni­cal­ly demand­ing lapar­os­cop­ic pro­ce­dure ­with a dif­fi­cult learn­ing ­curve, but can be per­formed system­at­i­cal­ly ­with stan­dard tech­niques. The advan­tag­es ­include short­er con­va­les­cence and mark­ed­ly low­er oper­a­tive ­blood ­loss, ­with quick­er remov­al of the uri­nary cath­e­ter. ­Long-­term func­tion­al and onco­log­ic ­results are not yet avail­able

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