Comparison of Perioperative Outcomes of Extraperitoneal Laparoscopic Radical Prostatectomy (ELRP) versus Open Radical Retropubic Prostatectomy (RRP): Single Surgeon's Initial Experience

Abstract

Purpose: Since its introduction into clinical practice, a laparoscopic radical prostatectomy (LRP) has been performed at a growing number of centers. LRP can be performed by either a transperitoneal or extraperitoneal approach. The perioperative morbidities were evaluated in two groups of patients; retropubic radical prostatectomy (RRP) or extraperitoneal laparoscopic radical prostatectomy (ELRP). Materials and Methods: Between December 2003 and March 2006, 45 patients were treated with a RRP, and between September 2005 and May 2006, 30 patients underwent an ELRP. The same surgeon performed both types of operation. The perioperative data, including operative time, transfusion rates, hospitalization length and duration of catheterization were analyzed. The pathological parameters, including Gleason score, pathological stage and positive surgical margin rates were also analyzed. Results: There were no significant differences in the preoperative characteristics between the two groups, with the exception of the mean age. The average operative time was significantly shorter in the RRP group (p 0.05). After gaining experience of 15 cases, the ELRP group showed significantly shorter catheterization time (p< 0.005) and hospital stay (p=0.098). The pathological parameters of the two groups were comparable. RRP group were more likely to larger amount of postoperative analgesia (p=0.072). Conclusions: The ELRP procedure showed comparable perioperative results to those of a RRP, with the exception of operative time. After our initial experience, the ELRP showed favorable outcomes with regard to catheterization time and hospital stay. Considering our results, ELRP can be recommended as one of the primary options for managing localized prostate cancer. (Korean J Urol 2007;48:131-137)