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4-Ports endoscopic extraperitoneal radical prostatectomy: preliminary and learning curve results.

Barbosa Hdo N, Siqueira TM, Barreto F, Menezes LG, Luna MJ, Calado AA - Int Braz J Urol (2016 May-Jun)

Bottom Line: As for the LRP technique performed by extraperitoneal access (ELRP), when performed by a single surgeon, the results are even scarcer.To analyze the early perioperative and oncologic results obtained with the ELRP, throughout the technical evolution of a single surgeon.A comparative analysis between the groups of efficacy results and ELRP safety was carried out.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Urologia da Universidade de Pernambuco - Recife, PE, Brasil.

ABSTRACT

Introduction: There is a lack of studies in our national scenario regarding the results obtained by laparoscopic radical prostatectomy technique (LRP). Except for a few series, there are no consistent data on oncological, functional, and perioperative results on LRP held in Brazil. As for the LRP technique performed by extraperitoneal access (ELRP), when performed by a single surgeon, the results are even scarcer.

Objective: To analyze the early perioperative and oncologic results obtained with the ELRP, throughout the technical evolution of a single surgeon.

Patients and methods: A non-randomized retrospective study was held in a Brazilian hospital of reference. In the 5-year period, 115 patients underwent the ELRP procedure. Patients were divided into two groups, the first 57 cases (Group 1) and the following 58 cases, (Group 2). A comparative analysis between the groups of efficacy results and ELRP safety was carried out.

Results: The average age of patients was 62.8 year-old and the PSA of 6.9ng/dl. The total surgery time was 135.8 minutes on average, and the urethral-bladder anastomosis was 21.9 min (23.3 min versus 20.7 min). The positive surgical margins (PSM) rate was 17.1%, showing no difference between groups (16.4% versus 17.9%; p=0.835). There was statistical difference between the groups in relation to the anastomosis time, estimated blood loss and the withdrawal time of the urinary catheter.

Conclusion: The ELRP technique proved to be a safe and effective procedure in the treatment of prostate cancer, with low morbidity.

No MeSH data available.


Related in: MedlinePlus

– Port closure with an umbilical point “X” on each side of the optical trocar.
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f02: – Port closure with an umbilical point “X” on each side of the optical trocar.

Mentions: The configurations of the ports were the same for all the cases. The camera port was done by an infraumbilical incision of about 4cm, followed by the digital dissection of the pre-peritoneal space and closed with Prolene thread (Figures 1 and 2). After Trendelenburg position (Figure-3), the surgeon’s work port was inserted into the edge of the rectus abdominis muscle at the midway between the iliac crest and the umbilicus, the left port had 5mm and the right one, 10-12mm. The 5mm port of the first assistant surgeon was inserted on the left side near the iliac crest. When the first assistant surgeon was left-handed this portal stood on the right side (Figure-4).


4-Ports endoscopic extraperitoneal radical prostatectomy: preliminary and learning curve results.

Barbosa Hdo N, Siqueira TM, Barreto F, Menezes LG, Luna MJ, Calado AA - Int Braz J Urol (2016 May-Jun)

– Port closure with an umbilical point “X” on each side of the optical trocar.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4920559&req=5

f02: – Port closure with an umbilical point “X” on each side of the optical trocar.
Mentions: The configurations of the ports were the same for all the cases. The camera port was done by an infraumbilical incision of about 4cm, followed by the digital dissection of the pre-peritoneal space and closed with Prolene thread (Figures 1 and 2). After Trendelenburg position (Figure-3), the surgeon’s work port was inserted into the edge of the rectus abdominis muscle at the midway between the iliac crest and the umbilicus, the left port had 5mm and the right one, 10-12mm. The 5mm port of the first assistant surgeon was inserted on the left side near the iliac crest. When the first assistant surgeon was left-handed this portal stood on the right side (Figure-4).

Bottom Line: As for the LRP technique performed by extraperitoneal access (ELRP), when performed by a single surgeon, the results are even scarcer.To analyze the early perioperative and oncologic results obtained with the ELRP, throughout the technical evolution of a single surgeon.A comparative analysis between the groups of efficacy results and ELRP safety was carried out.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Urologia da Universidade de Pernambuco - Recife, PE, Brasil.

ABSTRACT

Introduction: There is a lack of studies in our national scenario regarding the results obtained by laparoscopic radical prostatectomy technique (LRP). Except for a few series, there are no consistent data on oncological, functional, and perioperative results on LRP held in Brazil. As for the LRP technique performed by extraperitoneal access (ELRP), when performed by a single surgeon, the results are even scarcer.

Objective: To analyze the early perioperative and oncologic results obtained with the ELRP, throughout the technical evolution of a single surgeon.

Patients and methods: A non-randomized retrospective study was held in a Brazilian hospital of reference. In the 5-year period, 115 patients underwent the ELRP procedure. Patients were divided into two groups, the first 57 cases (Group 1) and the following 58 cases, (Group 2). A comparative analysis between the groups of efficacy results and ELRP safety was carried out.

Results: The average age of patients was 62.8 year-old and the PSA of 6.9ng/dl. The total surgery time was 135.8 minutes on average, and the urethral-bladder anastomosis was 21.9 min (23.3 min versus 20.7 min). The positive surgical margins (PSM) rate was 17.1%, showing no difference between groups (16.4% versus 17.9%; p=0.835). There was statistical difference between the groups in relation to the anastomosis time, estimated blood loss and the withdrawal time of the urinary catheter.

Conclusion: The ELRP technique proved to be a safe and effective procedure in the treatment of prostate cancer, with low morbidity.

No MeSH data available.


Related in: MedlinePlus