title: [Experience in reducing intraoperative blood loss in radical retropubic prostatectomy].
abstract: OBJECTIVE
  To search for an effective method of reducing intraoperative blood loss in radical retropubic prostatectomy (RRP).
  
  
  METHODS
  We performed RRP for 100 patients with prostate cancer, 50 (group A) with the Walsh or Poor method for handling the dorsal venous complex (DVC), and the other 50 (group B) through the following three additional procedures for hemostasis: first placing a #7 prophylactic suture in the distal position of DVC, then ligating the vascular bundle of the prostatic apex with continuous 4-0 Vicryl sutures, and lastly placing a 4-0 absorbable suture followed by freeing the neurovascular bundle (NVB) or freeing NVB before suturing the remained levator ani myofascia and the deep layer of Denovilliers' fascia above the rectal serosa with 4-0 Vicryl. We assessed the effects of the three hemostatic methods in RRP by comparing the volumes of intraoperative blood loss and transfusion, operation time and perioperative levels of hemoglobin.
  
  
  RESULTS
  There were no significant differences between groups A and B in age, PSA, Gleason score, clinical stage, prostate volume, operation time and perioperative hemoglobin levels (P>0.05). The volumes of intraoperative blood loss and transfusion were markedly higher in group A ([1103.00 +/- 528.03] ml and [482.00 +/- 364.60] ml) than in B ([528.00 +/- 258.96] ml and [140.00 +/- 266.28] ml) (P<0.05).
  
  
  CONCLUSIONS
  Intraoperative blood loss in RRP could be significantly decreased by placing a prophylactic hemostatic suture in the distal position of DVC, continuous suture of the vascular bundle of the prostatic apex after cutting off the urethra, and placing a fine absorbable suture above NVB or continuous suture of the remained levator ani mony fascia and the deep layer of Denovilliers'fascia above the rectal serosa with absorbable sutures after freeing NVB.
authors.affiliation: Department of Urology, Shanghai Punan Hospital, Shanghai 200125, China.
authors.forename: Ding-Yi
authors.initials: DY
authors.lastname: Liu
authors.forename: Qi
authors.initials: Q
authors.lastname: Tang
authors.forename: Wei-Mu
authors.initials: WM
authors.lastname: Xia
authors.forename: Ming-Wei
authors.initials: MW
authors.lastname: Wang
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Yan-Feng
authors.initials: YF
authors.lastname: Zhou
authors.forename: Jia-Shun
authors.initials: JS
authors.lastname: Yu
authors.forename: Chen-Long
authors.initials: CL
authors.lastname: Chu
authors.forename: Chong-Yu
authors.initials: CY
authors.lastname: Zhang
authors.forename: Zhou-Jun
authors.initials: ZJ
authors.lastname: Shen
authors.forename: Wen-Long
authors.initials: WL
authors.lastname: Zhou
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*