Evaluation of operative complications related to laparoscopic radical prostatectomy.
OBJECTIVE
In this decade, there have emerged many alternatives for the therapy of localized prostate cancer, such as brachytherapy, intensity modulated radiation therapy, high intensity focused ultrasound, and retropubic radical prostatectomy. In this retrospective study, we reviewed cases of complications related to laparoscopic radical prostatectomy (LRP) from our institution only, and we evaluated whether this procedure was minimally invasive or not.


METHODS
Between August 2000 and December 2006, a total of 160 patients in our institution underwent LRP as the definitive treatment for clinically localized prostate cancer. We analyzed not only the complications but also the operative time and blood loss to clarify the indications of LRP.


RESULTS
Major complications were defined as those requiring surgical intervention including laparoscopic repair. A total of nine major complications (5.63%) occurred in six patients (3.75%). In a Cox regression analysis, the estimated blood loss (P = 0.0069) and neoadjuvant hormonal therapy (P = 0.0019) were significant predictors of long operative time (>6 h) of LRP.


CONCLUSIONS
The indication of LRP in this study was localized prostate cancer at the T1 or T2 stage for which neoadjuvant hormonal therapy had not been administered. We concluded that the operative and postoperative morbidities of LRP are low and that LRP can be routinely carried out by an experienced team.
Tozawa
Keiichi
K
Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan. toza@med.nagoya-cu.ac.jp
Hashimoto
Yoshihiro
Y
Yasui
Takahiro
T
Itoh
Yasunori
Y
Nagata
Daisuke
D
Akita
Hidetoshi
H
Kawai
Noriyasu
N
Hayashi
Yutaro
Y
Kohri
Kenjiro
K
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D012189:Retrospective Studies