title: Early complication of anatomical radical retropubic prostatectomy: lessons from a single-center experience.
abstract: OBJECTIVE
  The purpose of this study is to report the rate of early complications in 316 of 600 patients who underwent anatomical radical retropubic prostatectomy for localized prostatic cancer from June 1988 to July 1996 and to measure the effect of increasing experience in a single institution.
  
  
  METHODS
  From January 1992 to August 1995, 316 patients with prostatic cancer underwent anatomical radical retropubic prostatectomy at our medical institution. Early complications were recorded prospectively and the rate of complications of the first 166 patients was compared with the rate in the next 150 patients.
  
  
  RESULTS
  Comparison of the 2 groups showed a significant decrease in blood loss with time (mean 1,397 vs. 967 cm3, p = 0.0011). The rates of anastomotic urinary leakage (21.7 vs. 10%, p = 0.0056), lymphoceles (22.3 vs. 2%, p < 0.0001), rectal injury (7.8 vs. 2%, p = 0.02), reoperation (10.2 vs. 4%, p = 0.049), and thromboembolic complications (7.8 vs. 2.7%, p = 0.0479) also decreased significantly. Only ureteral transsection showed an increase in the later group (0 vs. 4.7%, p = 0.005).
  
  
  CONCLUSIONS
  The low percentage of early complications suggests that anatomical retropubic radical prostatectomy is a safe approach. Our single-center study showed a learning pattern that appears unavoidable when this operation is as radical as possible so as to keep the percentage of positive margins low especially in patients with advanced tumors (> pT2).
authors.affiliation: Department of Urology, University of Hamburg, University Clinic Eppendorf, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Heinzer
authors.forename: M
authors.initials: M
authors.lastname: Graefen
authors.forename: J
authors.initials: J
authors.lastname: Noldus
authors.forename: P
authors.initials: P
authors.lastname: Hammerer
authors.forename: H
authors.initials: H
authors.lastname: Huland
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies