Laparoscopic radical prostatectomy: perioperative complications in an initial and consecutive series of 80 cases.
OBJECTIVE
We retrospectively evaluated the intraoperative and early postoperative complications of the initial experience with the first 80 laparoscopic radical prostatectomies performed at our institution.


METHODS
Between January 17, 2001 and July 24, 2002, 80 patients between 53 and 78 years old (mean age 63.8) with clinically localized prostate cancer underwent laparoscopic radical prostatectomy with the Montsouris technique. A total of 24 (30%) staging pelvic lymphadenectomy were performed. The inpatient and outpatient medical records as well as all complications were reviewed.


RESULTS
The pathological tumor stage revealed 18 pT2a (22.5%), 29 pT2b (36.25%), 21 pT3a (26.25%), 10 pT3b (12.5%), 1 pT4 (1.25%), 1 pT4 N1 (1.25%). No conversion was necessary in all cases. Mean operative time was 218 minutes (range 150-420) overall, mean blood loss was 376 ml (range 50-1000) and the mean postoperative hospital stay was 4.5 days (range 3-9). The mean and the median duration of bladder catheterization were respectively 11 and 10 days (range 7-23). Injury to the epigastric vessels was detected intraoperatively in 5 cases (6.25%) with immediate hemostasis achieved. There was 1 death (1.25%) 35 days after a cerebrovascular accident occurred on postoperative day 3. We observed 1 (1.25%) postoperative ileus, hemoperitoneum in 5 cases (6.25%), 2 (2.5%) acute urinary retentions, 6 (7.5%) anastomotic leakages, 1 (1.25%) anastomotic stricture, 1 (1.25%) hydrocele and 2 (2.5%) urinary tract infections.


CONCLUSIONS
In our initial experience laparoscopic radical prostatectomy was performed with no complications in 77.5% of patients. We observed major and minor complications respectively in 16.25% and 6.25% of the patients. Our series provides evidence that the laparoscopic approach is feasible and associated with acceptable perioperative morbidity.
Gregori
Andrea
A
Division of Urology, Department of Surgery, Luigi Sacco Hospital, Milan, Italy. greg001@libero.it
Simonato
Alchiede
A
Lissiani
Andrea
A
Bozzola
Andrea
A
Galli
Stefano
S
Gaboardi
Franco
F
D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001803:Blood Transfusion; D019074:Epigastric Arteries / Q000293:injuries; D006801:Humans; D045823:Ileus / Q000209:etiology / Q000628:therapy; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000009:adverse effects* / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011468:Prostatectomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D020521:Stroke / Q000209:etiology; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000209:etiology; D014552:Urinary Tract Infections / Q000209:etiology