Transperitoneal or extraperitoneal approach for laparoscopic radical prostatectomy: a false debate over a real challenge.
OBJECTIVE
With our extensive experience of transperitoneal laparoscopic prostatectomy, we evaluated the advantages and disadvantages of the extraperitoneal approach by comparing 2 consecutive series of each procedure.


METHODS
We reviewed 200 consecutive procedures performed by 2 surgeons. A total of 100 transperitoneal procedures (designated group 1) were compared to the first 100 extraperitoneal cases (designated group 2).


RESULTS
Mean operating time was 173 minutes in group 1 and shorter in group 2 at 163 minutes (p = 0.003). Mean blood loss (360 ml in group 1,375 ml in group 2) and transfusion rates (4% in group 1, 3% in group 2) were equivalent. There were no major complications. Minor complications were 10% in group 1 and 9% in group 2. There was no statistical difference in positive margin rate between groups 1 and 2.


CONCLUSIONS
The 2 procedures are equivalent in terms of operative, postoperative and pathological data. Each surgeon has to choose considering personal experience, training and standardization.
Cathelineau
X
X
Department of Urology, Institut Montsouris, University of Paris VI, France. xavier.cathelineau@imm.fr
Cahill
D
D
Widmer
H
H
Rozet
F
F
Baumert
H
H
Vallancien
G
G
D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010537:Peritoneum; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*