title: [Localized prostatic cancer: treatment with laparoscopic radical prostatectomy: study with 841 cases].
abstract: The authors present their experience in the technique of laparoscopic radical prostatectomy. After 841 operations done from January 1998 to april 2001. They use a trans peritoneal approach with 5 ports of 5 and 10 mm. The prostatectomy is done antegrady and the urethrovesical anastomosis is rebuilt with interrupted 3/0 resorbable sutures. Operating time is 2 hours and 40 minutes (1 h 30 to 6 h 30) Conversion rate is 0.9%, average bleeding is 330 cc and transfusion rate is 2.8%. Bladder catheter is removed between days 3 to 6. hospital stay is 5.8 days. Post-op pain is minimal (2% of antalgics at day 2). There was no death, no embolism, 0.2% of phlebitis, 1.1% of rectal injury. Anstomotic strictures occur in 0.3% of cases. 89.2% of patients are continent after 1 year and 75% of patients under 70 years old who underwent a bilateral nerve sparing procedure were potent at 6 months. Positive margins were observed in 5% of pT2a, 22.5% of pT2b, 22.7% in pT3a and 30% in PT3b. After 2 years 92.5% of patients pT2a and b have a PSA < 0.1 ng/ml. No port seeding or peritoneal invasion by cancer was observed. Laparoscopic radical prostatectomy is a safe surgical procedure which limits the risk of transfusion, of anastomotic stricture, which reduces post op pain and allows a good continence. Potency recovery is promising.
authors.affiliation: Institut Mutualiste Montsouris, Département d'urologie, 46 bld Jourdan-75674 Paris.
authors.forename: Guy
authors.initials: G
authors.lastname: Vallancien
authors.forename: Bertrand
authors.initials: B
authors.lastname: Guillonneau
authors.forename: Xavier
authors.initials: X
authors.lastname: Cathelineau
authors.forename: Hervé
authors.initials: H
authors.lastname: Baumert
authors.forename: Jean-Dominique
authors.initials: JD
authors.lastname: Doublet
mesh_terms: D006801:Humans; D010535:Laparoscopy; D008297:Male; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*