title: A matched-pair comparison of single plus one port versus standard extraperitoneal laparoscopic radical prostatectomy by a single urologist.
abstract: We conducted this study to report on our initial experience and assess the safety, feasibility, and efficacy of extraperitoneal single plus one port laparoscopic radical prostatectomy (SPOPL-RP), and determine whether it shows any objective advantage over standard laparoscopic radical prostatectomy. From June 2009 to September 2011, 15 extraperitoneal SPOPL-RPs were performed through a 2-3-cm subumbilical longitudinal incision and another 5-mm trocar placed at the McBurney point. This cohort was compared with 37 contemporary patients who underwent standard extraperitoneal laparoscopic radical prostatectomy performed by the same urologist. Peri- and postoperative outcomes, including continence, potency, and scar length, were statistically analyzed. The two groups were comparable with respect to patient demographics, estimated blood loss, drainage time, duration of catheterization, catheterization rate >14 days, complication rate, postoperative hospitalization, and postoperative functional and oncologic outcomes (p > 0.05). The SPOPL-RP procedures had a longer mean operative time (170.1 minutes vs. 139.5 minutes, p = 0.005), but with fewer patients requiring analgesics (20% vs. 54.1%, p = 0.038) and earlier resumption of oral intake (20.7 hours vs. 26.8 hours, p = 0.037). The mean scar length in the SPOPL-RP group was much smaller (3.4 cm vs. 5.8 cm, p = 0.000) owing to the significant reduction of the skin incision. The peri- and postoperative outcomes of SPOPL-RP for low-risk prostate cancer are comparable to those with the standard laparoscopic approach. In addition, SPOPL-RP provides better postoperative pain control, faster recovery of bowel function, and smaller scar length than standard laparoscopy, albeit with a longer operative time.
authors.affiliation: Department of Urologic Surgery, First Hospital of Ningbo City, Affiliated Medical School of Ningbo University, Ningbo, China.
authors.forename: Dong-Xu
authors.initials: DX
authors.lastname: Zhang
authors.affiliation: Department of Urologic Surgery, General Hospital of Beijing Military Command, Beijing, China.
authors.forename: Jing-Fei
authors.initials: JF
authors.lastname: Teng
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University Shanghai, Shanghai, China.
authors.forename: Xiu-Wu
authors.initials: XW
authors.lastname: Pan
authors.affiliation: Department of Urologic Surgery, Zhejiang Xiaoshan Hospital, Hangzhou, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University Shanghai, Shanghai, China. Electronic address: cuixingang_smmu@126.com.
authors.forename: Xin-Gang
authors.initials: XG
authors.lastname: Cui
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University Shanghai, Shanghai, China.
authors.forename: Dan-Feng
authors.initials: DF
authors.lastname: Xu
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University Shanghai, Shanghai, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University Shanghai, Shanghai, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University Shanghai, Shanghai, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Yin
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University Shanghai, Shanghai, China.
authors.forename: Jun-Kai
authors.initials: JK
authors.lastname: Wang
authors.affiliation: Department of Urologic Surgery, Changzheng Hospital of the Second Military Medical University Shanghai, Shanghai, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Chen
mesh_terms: D000368:Aged; D003710:Demography; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000592:standards*; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D010820:Physicians; D011182:Postoperative Care; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology; D014572:Urology
keywords: Laparoscopic radical prostatectomy; Prostate cancer; Single plus one port laparoscopic radical prostatectomy