Laparoscopic radical prostatectomy: assessment after 550 procedures.
OBJECTIVE
To evaluate our experience in laparoscopic radical prostatectomy.


METHODS
Between January 1998 and December 2000, 550 consecutive patients eligible for radical prostatectomy, were operated laparoscopically. Data concerning surgery and post-operative course were assessed and recorded. Oncological data were assessed by pathological examination and post-operative PSA level. Functional results were assessed with a self-questionnaire.


RESULTS
The mean operating time was 170 min for the last 350 patients. Surgical conversion was necessary in seven patients (1.3%). Mean intra-operative bleeding was 290 ml (range: 50-1500 ml) for the last 350 patients. The overall transfusion rate was 5.27%. Mean bladder catheterization time was 4.2 days and median postoperative stay was 5 days in the last 350 patients. By pathological stage, 4 pT2a specimens (3.3%), 48 pT2b specimens (15%), 21 pT3a specimens (33%), 19 pT3b specimens (47%) were found to have positive surgical margins. For pT2a and pT2b stages, non-biological recurrence probability (PSA<0.1 ng/ml) is, respectively, 92.3% at 36 months, and 86.3% at 31 months. The continence rate (no pad) was 82.3% at 12 months among the 255 first patients. For 47 consecutive selected patients, spontaneous erection rate was 85 and 66% experienced spontaneous intercourse.


CONCLUSIONS
Laparoscopic radical prostatectomy is currently feasible, with low perioperative morbidity. Taking into account the postoperative follow-up, oncological results are identical to those obtained with conventional surgery. The functional results are encouraging.
Department of Urology, Institut Mutualiste Montsouris, 42 boulevard Jourdan, Paris, France. bertrand.guillonneau@imm.fr
Bertrand
B
Guillonneau
Xavier
X
Cathelineau
Jean-Dominique
JD
Doublet
Hervé
H
Baumert
Guy
G
Vallancien
D006801:Humans; D010535:Laparoscopy; D008297:Male; D019990:Perioperative Care; D011183:Postoperative Complications; D011468:Prostatectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome