Document Detail


Feasibility and usefulness of laparoscopic radical prostatectomy: Kobe University experience.
MedLine Citation:
PMID:  12534908     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The objective of this study was to present the clinical outcomes of 26 patients who underwent laparoscopic radical prostatectomy at our institution. METHODS: We performed laparoscopic prostatectomy on patients who were clinical stage T1 or T2. The mean age was 70 years old (range: 52-76). The mean level of pre-treatment prostate-specific antigen (PSA) was 8.7 ng/mL (range: 3.3-45). The Gleason score of the needle biopsy was < 7 in 21 patients and > or = 7 in five patients. Clinical stage was T1c in 17 patients, T2a in 6 patients and T2b in 3 patients. Operative techniques followed those of the French groups. Five trocars were introduced into the peritoneal cavity. The vas deferens and seminal vesicles were dissected to reach the posterior wall of the prostate and the retroperitoneal space was dissected around the urinary bladder. Incision of endopelvic fascia and dorsal vein complex (DVC) ligation were performed. The bladder neck and prostate were divided, then the distal urethra was cut. The lateral pedicles of the prostate were cut and the entire prostate was removed. Vesico-urethral anastomosis was performed at eight points. RESULTS: Mean operation time was 7 h 30 min. Mean bleeding volume (including urine volume) was 850 mL (range: 32-3135). All patients underwent autologous blood transfusion. Only one patient required further blood transfusion. Gleason scores of resected specimens were < 7 in 10 patients, and > or = 7 in 16 patients. Pathological stage was T0 in 1 patient, T2a in 6 patients, T2b in 13 patients, T3a in 5 patients and T3b in 1 patient. The PSA value was undetectable in all patients one month after surgery. Ten patients who survived for 6 months after surgery had complete urinary continence without a pad. In 7 of the 12 patients who were potent before surgery, neurovascular bundles were preserved, and 5 of them (71%) achieved complete or incomplete erection 3 months after surgery. However, only one patient (14%) could have sexual intercourse. CONCLUSION: Although longer follow-up is necessary to evaluate this surgical technique, laparoscopic prostatectomy seems to be a reasonable option in the treatment of organ-confined prostate cancer.
Authors:
Isao Hara; Gaku Kawabata; Hideaki Miyake; Shoji Hara; Masato Fujisawa; Hiroshi Okada; Soichi Arakawa; Sadao Kamidono
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  International journal of urology : official journal of the Japanese Urological Association     Volume:  9     ISSN:  0919-8172     ISO Abbreviation:  Int. J. Urol.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2003-01-21     Completed Date:  2003-04-09     Revised Date:  2006-10-30    
Medline Journal Info:
Nlm Unique ID:  9440237     Medline TA:  Int J Urol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  635-40     Citation Subset:  IM    
Affiliation:
Department of Urology, Kobe University School of Medicine, Kobe, Japan. hara@med.kobe-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Feasibility Studies
Follow-Up Studies
Hospitals, University*
Humans
Japan
Laparoscopy*
Male
Middle Aged
Neoplasm Staging
Outcome Assessment (Health Care)
Prostate-Specific Antigen / blood
Prostatectomy*
Prostatic Neoplasms / blood,  pathology,  surgery*
Reproducibility of Results
Time Factors
Chemical
Reg. No./Substance:
EC 3.4.21.77/Prostate-Specific Antigen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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