title: Laparoscopic radical prostatectomy--the experience of the German Laparoscopic Working Group.
abstract: OBJECTIVE
  To present the current status of laparoscopic radical prostatectomy (LRP) in Germany, Austria and Switzerland with respect to transferability, learning curve, and outcome.
  
  
  METHODS
  The data of 5824 patients who underwent LRP in 18 centers by 50 urologists from March 1999 to August 2004 were analyzed retrospectively. Three centers performed more than 500, and six more than 250 cases. A transperitoneal descending technique with was used in 2701, a transperitoneal ascending in 1234, an extraperitoneal descending in 1814, and an extraperitoneal ascending modification in 75 cases. Specimen showed pT2 in 3535, pT3a in 1555, pT3b in 623, and pT4 in 111 cases.
  
  
  RESULTS
  Mean operating time averaged 211 (131-292) minutes, with shorter duration of the extraperitoneal descending technique. Conversion to open surgery averaged 2.4 (0-14.1) %. Re-intervention rate amounted to 2.7 (0.3-7.7) %. Complication rate averaged 8.9 (1.8-10.8) % including bleeding (0.3-2.5%) and rectal lesion (1.5-2.5%). The rate of positive margins was 10.6 (3.2-18) % for pT2- and 32.7 (20-38.5) % for pT3a-tumors Continence after 12 months was 84.9 (72-94) %. Data about potency (7 centers) revealed 52.5 (35-67) % full erections following bilateral nerve preservation. 5 year-PSA recurrence rate (3 centers) was 8.6 (4-15.3) % for pT2-tumors and 17.5 (15-20.6) % for pT3a-stages.
  
  
  CONCLUSIONS
  The results confirm the efficacy of the training program with safe transfer of LRP (i.e. low complication rate), however including all known problems of a retrospective study.
authors.affiliation: Department of Urology, SLK Kliniken Heilbronn, University of Heidelberg, Am Gesundbrunnen 20, D-77074 Heilbronn, Germany. jens.rassweiler@slk-kliniken.de
authors.forename: Jens
authors.initials: J
authors.lastname: Rassweiler
authors.forename: Jens
authors.initials: J
authors.lastname: Stolzenburg
authors.forename: Tullio
authors.initials: T
authors.lastname: Sulser
authors.forename: Serdar
authors.initials: S
authors.lastname: Deger
authors.forename: Jürgen
authors.initials: J
authors.lastname: Zumbé
authors.forename: Georg
authors.initials: G
authors.lastname: Hofmockel
authors.forename: Hubert
authors.initials: H
authors.lastname: John
authors.forename: Günther
authors.initials: G
authors.lastname: Janetschek
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Fehr
authors.forename: Martin
authors.initials: M
authors.lastname: Hatzinger
authors.forename: Michael
authors.initials: M
authors.lastname: Probst
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Rothenberger
authors.forename: Vassilis
authors.initials: V
authors.lastname: Poulakis
authors.forename: Michael
authors.initials: M
authors.lastname: Truss
authors.forename: Gralf
authors.initials: G
authors.lastname: Popken
authors.forename: Jens
authors.initials: J
authors.lastname: Westphal
authors.forename: Uwe
authors.initials: U
authors.lastname: Alles
authors.forename: Paolo
authors.initials: P
authors.lastname: Fornara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D005858:Germany; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D013557:Switzerland