title: Comparison of early oncologic results of laparoscopic radical prostatectomy by extraperitoneal versus transperitoneal approach.
abstract: OBJECTIVE
  Compare the early oncological results of laparoscopic radical prostatectomy performed by either an extraperitoneal or a transperitoneal approach.
  
  
  METHODS
  330 consecutive men underwent laparoscopic radical prostatectomy for localized prostate cancer, the first 165 by transperitoneal approach, and the last 165 by extraperitoneal approach. Clinical stage, serum PSA, Gleason score of biopsy were recorded, as well as operating time, surgical and medical complications, blood loss, length of hospital stay and catheterization time. The weight of the specimen, pathological stage (1997 TNM classification) and status of the surgical margins were noted. The Fisher test as well as the chi2-test were used for statistical analysis. Differences were considered significant when p < 0.05.
  
  
  RESULTS
  There were no significant differences between the two groups in terms of preoperative characteristics except for Gleason score of the biopsies which was higher in the extraperitoneal group (p < 0.0001). The operating time was longer with the transperitoneal approach (248.5 min vs. 220.0 min, p < 0.0001). There was no difference in transfusion rate (1.2% vs. 5.4%, transperitoneal vs. extraperitoneal, respectively, p = 0.6). There was no difference in hospital stay, medical and surgical complications. Respectively, in the transperitoneal and extraperitoneal groups, there were 108 and 88 pT2 tumors. There were no differences in terms of positive surgical margins between the two groups, 23% and 29.7% (p = 0.21) overall, 13.0% and 17.0% (p = 0.42) in pT2 tumors and 43.6% and 44.7% (p = 0.99) in pT3 tumors.
  
  
  CONCLUSIONS
  Extraperitoneal approach offers the same early oncological results as transperitoneal approach with a shorter operative time.
authors.affiliation: Service d'Urologie CHU Henri Mondor, 51. Av. Du Ml. de Lattre de Tassigny, 94010 Créteil cedex, France.
authors.forename: Leticia
authors.initials: L
authors.lastname: Ruiz
authors.forename: Laurent
authors.initials: L
authors.lastname: Salomon
authors.forename: András
authors.initials: A
authors.lastname: Hoznek
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Vordos
authors.forename: René
authors.initials: R
authors.lastname: Yiou
authors.forename: Alexandre
authors.initials: A
authors.lastname: de la Taille
authors.forename: Clément-Claude
authors.initials: CC
authors.lastname: Abbou
mesh_terms: D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010537:Peritoneum; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors