title: Laparoscopic radical prostatectomy: perioperative outcomes and morbidity of 559 consecutive cases in Siriraj Hospital, Thailand.
abstract: OBJECTIVE
  To evaluate perioperative outcomes and morbidity of laparoscopic radical prostatectomy in Siriraj Hospital during a 5-year experience.
  
  
  METHODS
  Five hundred fifty nine patients who underwent laparoscopic radical prostatectomy (LRP) by seven surgeons at Siriraj Hospital between September 2004 and September 2009 were included in the study. Data of perioperative results and postoperative parameters were retrospectively evaluated.
  
  
  RESULTS
  Mean operative time was 257 minutes SD 75 (range 125 to 680 min). The mean operative time of the first 100 cases was significantly higher than of the last 100 cases (307 ml/min SD 95 versus 223 ml/min SD 56; p-value = 0.001). Mean estimated blood loss was 779 ml SD 607 (range 40 to 6,000 ml). Of 559 patients, 148 patients (26.5%) had blood transfusions. The blood transfusion rate in the first 100 cases was significantly higher than those of the last 100 cases (36.5% versus 15%; p-value = 0.016). The median duration of catheterization time was 8 days. The mean time of drain insertion was 4.2 days SD 1.8 (range 2 to 18 days) postoperatively. Hospital stay was 8.8 days SD 7.6 (range 3 to 149 days). Overall perioperative complications rate was 17.1%. Of these patients, 13.4% were minor complication (Clavien 1, 2) and 3.7% were major complication (Clavien 3, 4). There were no mortalities. Late complication rate was 2.1%, which most of them were stricture of anastomosis.
  
  
  CONCLUSIONS
  Perioperative outcomes and morbidity of LRP in a 5-year period were acceptable. Laparoscopic radical prostatectomy is technically demanding with an initially longer operative time and higher blood transfusion rate. The learning curve of the surgical team is needed to achieve good results.
authors.affiliation: Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. tbuncha@hotmail.com
authors.forename: Buncha
authors.initials: B
authors.lastname: Thiptirapong
authors.forename: Sunai
authors.initials: S
authors.lastname: Leewansangtong
authors.forename: Chaiyong
authors.initials: C
authors.lastname: Nualyong
authors.forename: Sittiporn
authors.initials: S
authors.lastname: Srinualnad
authors.forename: Tawatchai
authors.initials: T
authors.lastname: Taweemonkongsap
authors.forename: Bansithi
authors.initials: B
authors.lastname: Chaiyaprasithi
authors.forename: Teeraporn
authors.initials: T
authors.lastname: Amornvesukit
authors.forename: Kittipong
authors.initials: K
authors.lastname: Phinthusophon
authors.forename: Siros
authors.initials: S
authors.lastname: Jitpraphai
authors.forename: Phisaiphun
authors.initials: P
authors.lastname: Wattayang
authors.forename: Phichaya
authors.initials: P
authors.lastname: Sujijantararat
authors.forename: Suchai
authors.initials: S
authors.lastname: Soontrapa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D059035:Perioperative Period; D011183:Postoperative Complications / Q000453:epidemiology; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome