title: Endoscopic extraperitoneal radical prostatectomy: the University of Leipzig experience of 2000 cases.
abstract: BACKGROUND
  Review of experience with endoscopic extraperitoneal radical prostatectomy (EERPE) for localized prostate cancer.
  
  
  METHODS
  2000 patients underwent EERPE. Mean age of the patients was 63.2 (41-77) years. Mean preoperative PSA was 10.2 ng/ml (0.64-82 ng/ml). 601 patients had undergone previous surgery. The functional and oncological outcomes were reviewed.
  
  
  RESULTS
  Mean operation time was 156 (50-320) min. Complication rate according to Clavien system was: 0.45% intraoperatively, 8.6% in the early and 0.3% in the late postoperative period. Positive surgical margins were found in 127 patients with pT2 stage (9.7%) and in 237 patients with pT3 stage (34.4%). 44/937 lymphadenectomies (4.7%) had positive lymph nodes. Mean catheterization time was 6.3 days. After 12 months, 92% of the patients were completely continent, 7% needed 1-2 pads/day and 1% used more than 2 pads daily.730 patients underwent nerve sparing procedure. The 12 month potency rates with or without administration of PDE 5 inhibitors were 34.1% in the unilateral nerve sparing group and 67.7% in the bilateral group. In the intrafascial nsEERPE group, after 12 months, 93.2% of the patients were completely continent, 7.1% required 1-2 pads per day and 0.6% more than 2 pads per day. Twelve months potency rate for unilateral and bilateral nerve sparing intrafascial procedure was 33.3% and 78.5 % respectively. The rate of positive surgical margins was 6.3% in pT2 and 21.2% in pT3 specimens.
  
  
  CONCLUSIONS
  Functional and oncological results of this large series are promising. The recently introduced intrafascial nsEERPE further improves the outcome of the procedure.
authors.affiliation: Department of Urology, University of Leipzig, Germany. stolj@medizin.uni-leipzig.de
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Stolzenburg
authors.forename: Robert
authors.initials: R
authors.lastname: Rabenalt
authors.forename: Minh
authors.initials: M
authors.lastname: Do
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kallidonis
authors.forename: Evangelos N
authors.initials: EN
authors.lastname: Liatsikos
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy; D005858:Germany; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D010537:Peritoneum / Q000601:surgery*; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology