Oncological and Functional Results of Laparoscopic Radical Prostatectomy after 100 Procedures: Our Experience

Materials and Methods

Between January 2005 and December 2007, 100 laparoscopic radical prostatectomies were performed by one surgeon. We retrospectively reviewed margins status, operative time, blood transfusion rates, time of catheterization, length of hospital stay, continence and potency rates.

Results

The operative time decreased during the learning curve. The mean duration of surgery was 240 minutes (in the first 25 procedures the median time was 320 minutes, while in the last 25 cases the mean duration was 200 minutes).

Five conversions to open surgery were required owing to failure to progress. The overall rate of positive surgical margins was 15% in pT2 and 35% in pT3a tumors. We had 3 minor complications (two anastomotic leakage and one hemorrhage from the anastomosis) and 2 major complications (recto-urethral fistula).

The mean intraoperative blood loss was 450 ml (range 200–1500). With regard to transfusion, 25 patients (25%) received their autologous units, while 2% of the patients required homologous units.

The mean duration of catheterization was 7.8 days.

The continence rate at 12 months was 85%; the potency rate was 55% at 12 months.

Conclusions

The results of the present study show that by using a rational approach to training, a general urologist with low experience in laparoscopy is able to safely perform laparoscopic radical prostatectomy, and with oncological and functional results comparable to those of other published series.