2009, Number 3
Rev Mex Urol 2009; 69 (3)
López-Verdugo JF, Vargas-Valtierra P, Fernández-González AH, Camacho-Trejo VF, Zapata-González JA
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ABSTRACTObjective: To analyze laparoscopic radical prostatectomy (LRP) results obtained over the last two years.
Materials and methods: Case records of patients diagnosed with prostate cancer (CaP) who consecutively underwent LRP from August 1, 2006 to July 31 2008 (n = 115) were reviewed. Mean age, clinical tumor stage (TNM), prostate specific antigen (PSA), Gleason score (pre- and postoperative), surgery duration, bleeding, hospitalization duration, morbidity, mortality, urinary continence and postoperative sexual potency were all evaluated.
Results: A total of 115 case records were reviewed. Patient age was from 48 to 78 years with a mean age of 62 years and standard deviation (SD) of ± 6.9 and the most frequent age was 60 years. Morbidity was 8.6% and mortality was 0.8%. Clinical stage varied from T1a to T3b. One hundred patients presented with PSA ‹ 20 ng/ml, with a mean 8.6 and SD ± 3.2. The remaining 15 patients underwent pelvic lymphadenectomy. Preoperative Gleason score was in a range of 3 to 7, with a mode of 7, and the 3+4 score was predominant (23% patients). A total of 24 intrafascial surgeries and 91 extrafascial surgeries were performed (42 nerve-sparing and 73 non-nervesparing procedures). Thirty-nine patients underwent urethropexy and 29 underwent lymphadenectomy. Mean surgery duration was 164 minutes (90 to 420 min range and SD ± 50 min). Mean intraoperative bleeding was 384 ml (100-1800 ml range and SD ± 276 ml) and mean hospitalization duration was 3.3 days (1 to 12 day range and SD ± 1.3). There were no conversions to open surgery. Urinary continence at 8, 30, and 90 days presented in 42.95%, 82.4% and 97.3% of patients, respectively. There was absence of erection in 18 patients prior to surgery and of the remaining 97 patients, 31 (31.6%) presented with absence of erection after surgery.
Oncological Results: Four patients presented with positive margins (3.5%) and mean PSA at 3 and 6 months was 0.058 and 0.08 ng/ml, respectively.
Conclusions: The results of this series are similar to those published by other authors. Reduced procedure morbidity, low complication rate and excellent oncological and function-preserving results make LRP an ideal treatment for CaP.