title: Laparoscopic radical prostatectomy: functional and oncological outcomes.
abstract: OBJECTIVE
  Laparoscopic radical prostatectomy has become an accepted alternative to open surgery, however data on the functional and oncological outcome are still lacking. In this study we present an analysis based on a survey of the current literature and the first 500 patients treated with the Heilbronn technique. Additionally, we compare the results of laparoscopy with those of open radical prostatectomy.
  
  
  RESULTS
  We conducted an extensive MEDLINE search of laparoscopic and open radical prostatectomy from 1999 through 2003, focusing on the last 3 years. The articles as well as our own results were analyzed with respect to continence, potency, positive margins, prostatic specific antigen failure, and clinical progression. No significant differences were found between the laparoscopic and open approach with respect to overall continence at 12 months (60-94% versus 61-98%) or at 3 months (51-63% versus 62-69%), varying from 4.1% at pT2, 12% at pT3 to 19% at pT4 stages. We found no significant differences between the two techniques in the recovery of potency (34-67% versus 31-79%), if one excludes the selected series of Walsh with a mean age of 57 years. Furthermore, we did not detect any significant differences in positive margins and short-term prostatic specific antigen recurrence (3 years).
  
  
  CONCLUSIONS
  At centers of expertise, laparoscopic radical prostatectomy is able to provide similar functional and oncological results as its open counterpart, however with the advantages of minimally invasive surgery.
authors.affiliation: Department of Urology, Klinikum Heilbronn, University of Heidelberg, Am Gesundbrunnen 20, D-74074 Heilbronn, Germany. jens.rassweiler@klinikum-heilbronn.de
authors.forename: Jens
authors.initials: J
authors.lastname: Rassweiler
authors.forename: Michael
authors.initials: M
authors.lastname: Schulze
authors.forename: Dogu
authors.initials: D
authors.lastname: Teber
authors.forename: Othmar
authors.initials: O
authors.lastname: Seemann
authors.forename: Thomas
authors.initials: T
authors.lastname: Frede
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D010410:Penile Erection; D011468:Prostatectomy / Q000379:methods* / Q000534:rehabilitation; D011471:Prostatic Neoplasms / Q000601:surgery*; D020127:Recovery of Function; D016896:Treatment Outcome