Experience of 100 Laparoscopic Radical Prostatectomies Performed by a Single Surgeon: An Analysis of Surgical and Functional

다국어 초록 (Multilingual Abstract)

Purpose: This study was conducted to perform a comparative analysis of the efficacy and the safety of conventional transurethral resection of prostate (TUR-P), transurethral resection in saline (TURIS) and TURIS-plasma vaporization (TURIS-V) when performed by a single surgeon for benign prostate hyperplasia (BPH).
Materials and Methods: The clinical data of 73 consecutive men who underwent conventional TUR-P (39), TURIS (19) or TURIS-V (15) for BPH was retrospectively analyzed. All procedures were carried out by single surgeon between October 2007 and April 2010. Patients were assessed preoperatively and perioperatively, and were followed at 1, 3 and 6 months postoperatively. Patient baseline characteristics, perioperative data and postoperative outcomes were compared, and major complications were recorded.
Results: In all groups, significant improvements in subjective and objective voiding parameters were achieved and were sustained throughout follow-up. TURIS-V had the shortest operation time compared with conventional TUR-P and TURIS (P=0.211). TURIS-V significantly decreased procedural irrigation fluid volume, postoperative irrigation duration, catheter duration and hospital stay compared with conventional TUR-P and TURIS. There were no significant differences between groups in hemoglobin levels and serum sodium levels before and after the operations. There were three transfusions and four clot retentions in the TUR-P group, and one transfusion and one clot retention in the TURIS group. The TURIS-V group had no complications.
Conclusions: TURIS and TURIS-V were effective for the surgical treatment of BPH in addition to conventional TUR-P. TURIS-V was superior to conventional TUR-P and TURIS in terms of safety.

참고문헌 (Reference)

1 박성열, "로봇 보조 복강경 전립선적출술: 200례의 임상경험" 대한비뇨기과학회 49 (49): 215-220, 2008

2 이혜원, "단일 술자에 의한 복강경 근치적 전립선적출술과 로봇 보조 복강경 근치적 전립선적출술의 초기 수술 결과 비교" 대한비뇨기과학회 50 (50): 468-474, 2009

3 Guillonneau B, "Update of the morbidity of radical retropubic prostatectomy: retrospective analysis of 100 consecutive operations during the period 1996-1997" 9 : 662-667, 1999

4 Quinlan DM, "Sexual function following radical prostatectomy: influence of preservation of neurovascular bundles" 145 : 998-1002, 1991

5 Hu JC, "Role of surgeon volume in radical prostatectomy outcomes" 21 : 401-405, 2003

6 Ahlering TE, "Robotic radical prostatectomy: a technique to reduce pT2 positive margins" 64 : 1224-1228, 2004

7 Joseph JV, "Robot-assisted vs pure laparoscopic radical prostatectomy: are there any differences" 96 : 39-42, 2005

8 Rozet F, "Robot-assisted versus pure laparoscopic radical prostatectomy" 24 : 171-179, 2006

9 Patel VR, "Robot-assisted laparoscopic radical prostatectomy: perioperative outcomes of 1500 cases" 22 : 2299-2305, 2008

10 Bianco FJ Jr, "Radical prostatectomy: long-term cancer control and recovery of sexual and urinary function ("trifecta")" 66 : 83-94, 2005

11 Salomon L, "Radical prostatectomy by the retropubic, perineal and laparoscopic approach: 12 years of experience in one center" 42 : 104-110, 2002

12 Bhayani SB, "Prospective comparison of short-term convalescence: laparoscopic radical prostatectomy versus open radical retropubic prostatectomy" 61 : 612-616, 2003

13 Pierorazio PM, "Preoperative risk stratification predicts likelihood of concurrent PSA-free survival, continence, and potency (the trifecta analysis) after radical retropubic prostatectomy" 70 : 717-722, 2007

14 Eastham JA, "Predicting an optimal outcome after radical prostatectomy: the trifecta nomogram" 179 : 2207-2210, 2008

15 Zorn KC, "Planned nerve preservation to reduce positive surgical margins during robot-assisted laparoscopic radical prostatectomy" 22 : 1303-1309, 2008

16 Katz R, "Patient reported sexual function following laparoscopic radical prostatectomy" 168 : 2078-2082, 2002

17 Dahl DM, "Pathologic outcome of laparoscopic and open radical prostatectomy" 68 : 1253-1256, 2006

18 Ghavamian R, "Overcoming the steep learning curve of laparoscopic radical prostatectomy: single-surgeon experience" 18 : 567-571, 2004

19 Herrmann TR, "Oncological and functional results of open, robot-assisted and laparoscopic radical prostatectomy: does surgical approach and surgical experience matter" 25 : 149-160, 2007

20 Rassweiler J, "Laparoscopic versus open radical prostatectomy: a comparative study at a single institution" 169 : 1689-1693, 2003

21 Guillonneau B, "Laparoscopic radical prostatectomy: the Montsouris technique" 163 : 1643-1649, 2000

22 Poulakis V, "Laparoscopic radical prostatectomy: prospective evaluation of the learning curve" 47 : 167-175, 2005

23 Guillonneau B, "Laparoscopic radical prostatectomy: assessment after 240 procedures" 28 : 189-202, 2001

24 Martina GR, "Laparoscopic extraperitoneal radical prostatectomy--learning curve of a laparoscopy-naive urologist in a community hospital" 65 : 959-963, 2005

25 Hsu EI, "Influence of body weight and prostate volume on intraoperative, perioperative, and postoperative outcomes after radical retropubic prostatectomy" 61 : 601-606, 2003

26 Badani KK, "Evolution of robotic radical prostatectomy: assessment after 2766 procedures" 110 : 1951-1958, 2007

27 Litwin MS, "Epidemiological trends and financial outcomes in radical prostatectomy among Medicare beneficiaries, 1991 to 1993" 160 : 445-448, 1998

28 Stolzenburg JU, "Endoscopic extraperitoneal radical prostatectomy: the University of Leipzig experience of 2000 cases" 22 : 2319-2325, 2008

29 Frota R, "Comparison of radical prostatectomy techniques: open, laparoscopic and robotic assisted" 34 : 259-268, 2008

30 Park JW, "Comparative assessment of a single surgeon's series of laparoscopic radical prostatectomy: conventional versus robot-assisted" 25 : 597-602, 2011