[Early results in the initial 15 cases of laparoscopic radical prostatectomy in Akita University Medical Center].
We herein report our experience and early results of laparoscopic radical prostatectomy in 15 cases of localized prostate cancer (11 T1c and 4 T2a tumors) performed between March 2000 and October 2001. The operative procedure was almost identical to the Montsouris technique. Conversion to the open procedure was required only in the first case because of a widely opened bladder neck that involved the ureteral orifice. No severe intraoperative or postoperative complications were observed. The mean operating time and blood loss was 383 minutes and 640 ml including intraoperative urine, respectively. Only one patient required blood transfusion. All 14 patients with a successful procedure could take fluid and walk freely on postoperative day 1. Twelve (86%) of the 14 patients could take food on postoperative day 1 and a Foley catheter was successfully removed on day 6 to 8 in 12 (86%) cases. Histologically, positive surgical margin was observed in 5 (33%) cases and all of them were considered non-organ confined (pT3 or more). Without adjuvant hormonal therapy, biochemical (PSA) failure was observed in 5 (36%) cases (median follow-up period: 11 months). Continence has been well maintained in 12 patients with no need for a pad by 3 months postoperatively and 2 patients are using only 1 pad/day for caution's sake. In terms of early postoperative recovery, intraoperative blood loss and maintenance of continence, laparoscopic radical prostatectomy may give a satisfactory result. Although long-term follow-up is required to assess disease control and maintenance of sexual function, laparoscopic radical prostatectomy may become an alternative for the treatment of organ-confined prostate cancer.
Habuchi
Tomonori
T
Department of Urology, Akita University School of Medicine.
Iinuma
Masahiro
M
Sato
Kazunari
K
Sato
Shigeru
S
Matsuura
Shinobu
S
Shimoda
Naotake
N
Tsuchiya
Norihiko
N
Mitsumori
Kenji
K
Kato
Tetsuro
T
D000368:Aged; D015992:Body Mass Index; D006785:Hospitals, University; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods* / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000601:surgery*