4-Ports endoscopic extraperitoneal radical prostatectomy: preliminary and learning curve results.
BACKGROUND
There is a lack of studies in our national scenario regarding the results obtained by laparoscopic radical prostatectomy technique (LRP). Except for a few series, there are no consistent data on oncological, functional, and perioperative results on LRP held in Brazil. As for the LRP technique performed by extraperitoneal access (ELRP), when performed by a single surgeon, the results are even scarcer.


OBJECTIVE
To analyze the early perioperative and oncologic results obtained with the ELRP, throughout the technical evolution of a single surgeon.


METHODS
A non-randomized retrospective study was held in a Brazilian hospital of reference. In the 5-year period, 115 patients underwent the ELRP procedure. Patients were divided into two groups, the first 57 cases (Group 1) and the following 58 cases, (Group 2). A comparative analysis between the groups of efficacy results and ELRP safety was carried out.


RESULTS
The average age of patients was 62.8 year-old and the PSA of 6.9ng/dl. The total surgery time was 135.8 minutes on average, and the urethral-bladder anastomosis was 21.9 min (23.3 min versus 20.7 min). The positive surgical margins (PSM) rate was 17.1%, showing no difference between groups (16.4% versus 17.9%; p=0.835). There was statistical difference between the groups in relation to the anastomosis time, estimated blood loss and the withdrawal time of the urinary catheter.


CONCLUSIONS
The ELRP technique proved to be a safe and effective procedure in the treatment of prostate cancer, with low morbidity.
Departamento de Urologia da Universidade de Pernambuco - Recife, PE, Brasil.
Humberto do Nascimento
Hdo N
Barbosa
Departamento de Urologia da Universidade de Pernambuco - Recife, PE, Brasil.
Tiberio Moreno
TM
Siqueira
Departamento de Urologia, IMIP, Recife, PE, Brasil.
Francualdo
F
Barreto
Serviço de Urologia, Memorial São José Hospital, Recife, PE, Brasil.
Leonardo Gomes
LG
Menezes
Serviço de Urologia, Memorial São José Hospital, Recife, PE, Brasil.
Mauro Jose Catunda
MJ
Luna
Departamento de Urologia da Universidade de Pernambuco - Recife, PE, Brasil.
Adriano Almeida
AA
Calado
D000368:Aged; D000714:Anastomosis, Surgical; D001938:Brazil; D006801:Humans; D010535:Laparoscopy / Q000193:education / Q000379:methods* / Q000706:statistics & numerical data; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D061646:Operative Time; D059035:Perioperative Period; D011183:Postoperative Complications; D011184:Postoperative Period; D011468:Prostatectomy / Q000193:education / Q000379:methods* / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome