title: Ligation-free technique for dorsal vascular complex control during laparoscopic radical prostatectomy: a single-center experience from China.
abstract: OBJECTIVE
  To illustrate a ligation-free technique and compare perioperative and postoperative outcomes of this technique versus the standard suture method.
  
  
  METHODS
  This study is a retrospective review of 233 consecutive patients with localized prostate cancer who underwent ligation-free technique (n = 180, Group 1) or standard ligation (n = 53, Group 2) at an academic institution from February 2010 to January 2014.
  
  
  CONCLUSIONS
  Operative time was significantly shorter in Group 1 than in Group 2 (148.47 vs. 164.25 min, p = 0.000). No difference in EBL was noted between the groups (191.11 vs. 185.06 mL, p = 0.055). Postoperative continence rates at 3, 6, and 12 months in Groups 1 and 2 were 40.0 versus 24.5, 54.4 versus 37.7, and 73.9 versus 71.7 %, respectively. These differences were statistically significant. No patient in either group had a positive apical surgical margin. During follow-up, tumor recurrence or metastasis was not observed in any patient. Limitations of the study include this retrospective study of a single-center experience and lack of potency appraisal.
  
  
  CONCLUSIONS
  This present ligation-free technique showed a statistically significant shorter interval to recovery of continence and higher continence rates in short-term postoperative results by contrast to conventional suture ligation, but no significant difference was revealed in long-term urinary control. We offer this technique and the correlative data to provide more information for deeply understanding the precise construction of the dorsal vascular complex and the mechanism of urinary control.
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, No. 253 Industrial Road, Haizhu District, Guangzhou, 510282, Guangdong, People's Republic of China.
authors.forename: Peng
authors.initials: P
authors.lastname: Xu
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, No. 253 Industrial Road, Haizhu District, Guangzhou, 510282, Guangdong, People's Republic of China.
authors.forename: Abai
authors.initials: A
authors.lastname: Xu
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, No. 253 Industrial Road, Haizhu District, Guangzhou, 510282, Guangdong, People's Republic of China.
authors.forename: Binshen
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, No. 253 Industrial Road, Haizhu District, Guangzhou, 510282, Guangdong, People's Republic of China.
authors.forename: Shaobo
authors.initials: S
authors.lastname: Zheng
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, No. 253 Industrial Road, Haizhu District, Guangzhou, 510282, Guangdong, People's Republic of China.
authors.forename: Yawen
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, No. 253 Industrial Road, Haizhu District, Guangzhou, 510282, Guangdong, People's Republic of China.
authors.forename: Hulin
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, No. 253 Industrial Road, Haizhu District, Guangzhou, 510282, Guangdong, People's Republic of China.
authors.forename: Bingkun
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, No. 253 Industrial Road, Haizhu District, Guangzhou, 510282, Guangdong, People's Republic of China.|Innovation Center Okayama for Nanobio-targeted Therapy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Peng
authors.initials: P
authors.lastname: Huang
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, No. 253 Industrial Road, Haizhu District, Guangzhou, 510282, Guangdong, People's Republic of China.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, No. 253 Industrial Road, Haizhu District, Guangzhou, 510282, Guangdong, People's Republic of China.
authors.forename: Yukun
authors.initials: Y
authors.lastname: Ge
authors.affiliation: Department of Urology, Zhujiang Hospital, Southern Medical University, No. 253 Industrial Road, Haizhu District, Guangzhou, 510282, Guangdong, People's Republic of China. yihuixp88@hotmail.com.
authors.forename: Chunxiao
authors.initials: C
authors.lastname: Liu
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D002681:China; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008026:Ligation; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D009367:Neoplasm Staging; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D011467:Prostate / Q000098:blood supply*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013536:Suture Techniques; D014549:Urinary Incontinence / Q000453:epidemiology*
keywords: Dorsal vascular complex; Laparoscopic radical prostatectomy; Ligation-free technique; Prostate cancer; Urinary continence