Editorial Comment

Abstract

The author's institution, Division of Urology, Kobe University Graduate School of Medicine, has already reported on the surgical outcome of laparoscopic radical prostatectomy (LRP). This is the first report in Japan that compares open radical retropubic prostatectomy (RRP) with oncologic results of LRP.1 It is a very useful report for directly comparing the surgical margin status between RRP and LRP in the same institution. On the other hand, it is regrettable that the oncologic results of LRP are worse than the reports from Europe and the USA. It is clear that the lack of surgical skill meant that the proportion of multiple positive surgical margins in the LRP group was significantly greater than that in the RRP group. It was suggested that 137 LRP cases is not enough to acquire the surgical skills for RRP. This paper highlights future problems for LRP in that the incidences of positive surgical margins at the apex, posterior site and bladder neck in the LRP group were significantly greater than those in the RRP group. Laparoscopic procedures are at a higher technical level than open procedures. It is therefore necessary to achieve technical learning and improvement in less severe cases, particularly in the apex and bladder neck procedures.