title: Minimum incision endoscopic radical prostatectomy: clinical and oncological outcomes at a single institute.
abstract: OBJECTIVE
  The objective of this study was to investigate the clinical and oncological outcomes of prostatectomy patients undergoing minimum incision endoscopic radical prostatectomy (MIE-RP).
  
  
  METHODS
  Between September 2005 and May 2010, 541 patients underwent MIE-RP with bilateral lymphadenectomy for clinically localized prostate cancer at Hirosaki University Hospital. The present retrospective study enrolled 375 patients who had not received neoadjuvant or adjuvant therapy. MIE-RP was performed through a 6-cm suprapubic midline incision. A 30° laparoscope was conveniently positioned on the head side of the patient for precise observation and monitoring.
  
  
  RESULTS
  The median operating time was 119 min, and the estimated blood loss was 900 ml. The most frequent perioperative complication was leakage from the vesicourethral anastomosis (6.7%), and rectal injury occurred in 1.0%. Overall, 31.2% of the patients had a positive surgical margin, including 11.1% with pT2, 52.9% with pT3 and 100% with pT4 diseases. The post-operative median follow-up period was 40.5 months (range, 2-56.5 months). The 5-year PSA-free survival rate was 71.6%. In multivariate analysis, high-risk patients (according to the D'Amico risk criteria), pathological T stage and positive surgical margins were identified as independent predictors of PSA-free survival. The limitations of this study included a retrospective study, relatively short follow-up period and single-institution nature of the study.
  
  
  CONCLUSIONS
  MIE-RP is a safe and minimally invasive procedure that may represent a reliable alternative to laparoscopic and robotic-assisted RP.
authors.affiliation: Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki 036 8562, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Koie
authors.forename: H
authors.initials: H
authors.lastname: Yamamoto
authors.forename: S
authors.initials: S
authors.lastname: Hatakeyama
authors.forename: S
authors.initials: S
authors.lastname: Kudoh
authors.forename: T
authors.initials: T
authors.lastname: Yoneyama
authors.forename: Y
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: N
authors.initials: N
authors.lastname: Kamimura
authors.forename: C
authors.initials: C
authors.lastname: Ohyama
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D004724:Endoscopy; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000401:mortality / Q000601:surgery*; D012371:Robotics; D015996:Survival Rate