title: Evaluation of the outcome of laparoscopic radical prostatectomy by a single surgeon: experience with an initial 30 cases.
abstract: OBJECTIVE
  We carried out this study to clarify whether operative methods of laparoscopic prostatectomy (LRP) could become a standard therapy. The purpose was to evaluate the technical feasibility, oncologic effectiveness and perioperative and postoperative morbidity of LRP performed by a general urologist.
  
  
  METHODS
  Between June 2004 and May 2006, 30 patients with clinically localized prostate cancer consecutively underwent LRP by a single surgeon. Oncologic data were assessed by histopathological examination and by postoperative prostate-specific antigen (PSA) levels.
  
  
  RESULTS
  Complete laparoscopic removal of the prostate and seminal vesicles was achieved in all 30 patients. The average operation time was 250.9 min (range, 168 to 394 min). The total positive surgical margin rate was 20.7% (6 of 29 cases), with a total PSA recurrence rate was 23.3% (7 of 30 cases), but the frequencies tended to be decreased in the later phase cases. Perioperative complications were encountered in 5 patients; four of these patients were in the initial 10 cases. Two of the 30 cases (6.7%) required a blood transfusion (first case and 11th case). There were three surgical complications, one ureter injury, one rectal injury and one sigmoid serosal injury. The catheter duration intervals were reduced in the later cases.
  
  
  CONCLUSIONS
  From our experience with one surgeon, with whom perioperative complications were concentrated in the initial 10 cases, we conclude that LRP should be performed by experienced surgeons after intensive training.
authors: Department of Urology, Anjo Kosei Hospital, Anjo, Japan ; Department of Nephro-urology, Nagoya City University, Graduate School of Medical Science, Nagoya, Japan.
authors: Hidetoshi
authors: H
authors: Akita
authors: Department of Urology, Anjo Kosei Hospital, Anjo, Japan.
authors: Takehiko
authors: T
authors: Okamura
authors: Department of Nephro-urology, Nagoya City University, Graduate School of Medical Science, Nagoya, Japan.
authors: Taku
authors: T
authors: Naiki
authors: Department of Urology, East Medical Center Higashi Municipal Hospital City of Nagoya, Nagoya, Japan.
authors: Daisuke
authors: D
authors: Nagata
authors: Department of Nephro-urology, Nagoya City University, Graduate School of Medical Science, Nagoya, Japan.
authors: Keiichi
authors: K
authors: Tozawa
authors: Department of Nephro-urology, Nagoya City University, Graduate School of Medical Science, Nagoya, Japan.
authors: Kenjiro
authors: K
authors: Kohri
keywords: laparoscopic radical prostatectomy; prostate cancer
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