[Intraoperative complications and morbidity of laparoscopic radical prostatectomy (LRP) during the learning curve].
OBJECTIVE
To analyze the complications and morbidity during our learning curve of laparoscopic radical prostatectomy (LRP) and compare them with other published series.


METHODS
We review the 25 first laparoscopic radical prostatectomies performed in our department, evaluating the operative technique and other features such as surgical time, blood loss, complications and conversion to open surgery. We also evaluate morbidity, postoperative hospital stay, and functional features such as potency and continence.


RESULTS
LRP was completed in 22 patients. Overall intraoperative complication rate was 32%. 3 cases were converted to open surgery due to technical difficulties or intraoperative complications. We had complications in 4 patients, that were not severe (bladder injury 2 cases, and epigastric artery injury another 2) and where solved without difficulties during the operation. The most severe intraoperative complication was related to the anesthesia procedure at the time of extubation of a patient who required tracheotomy. There were no severe postoperative complications, being leakage from the anastomosis the most common (7 cases). All of them were managed conservatively, although this resulted in a mean hospital stay of 10.8 days. 2 patients required endoscopic procedures in the immediate postoperative time for bladder catheter repositioning. All patients suffered erectile dysfunction and the continence rate at 3 months was 77.2%.


CONCLUSIONS
Although LRP is a long operation and difficult during the learning curve, its complication rate is acceptable because they are not severe and can be managed in a relatively easy way.
Amón Sesmero
José H
JH
Servicio de Urología, Hospital Universitario "Pio del Rio Hortega", Valladolid, España. jhamon@terra.es
Estébanez Zarranz
Javier
J
Conde Redondo
Consuelo
C
Rodríguez Toves
Antonio
A
Robles Samaniego
Alberto
A
Valle del González
Noelia
N
Castroviejo Royo
Fátima
F
Martínez-Sagarra
José Ma
JM
D000368:Aged; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011468:Prostatectomy / Q000009:adverse effects* / Q000193:education* / Q000379:methods