Comparative Study On The Curative Effect Of Laparoscopic And Retropubic Radical Prostatectomy

PURPOSETo compare and evaluate the outcomes and security between laparoscopic radical prostatectomy and open retropubic radical prostatectomy as the treatment of localized prostate callcer.MATERIALS AND METHODSThe clillical data of150cases of patients underwent laparoscopic radical prostatectomy and80cases of patients underwent open retropubic radical prostatectomy were analyzed retrospectively at our Institute between June2003and July2011. Indexes of preoperative parameters, operating time, bleeding volume during operation, blood transfusions rate, pain score after operation,recovery time of intestinal function, the duration of catheterization, hospitalization stay after operation, complications, continence rate, potency rate and biochemical recurrence of the procedures were compared.RESULTSTwo groups were all successfully performed. No patient was converted to open surgery in the LRP group. The mean operating time of the LRP group and the RRP group were (218.79±77.32) minutes and (165.38±36.92)minutes,and there was statistical difference between these two groups(P<0.01).The mean operating time of per-75cases and post-75cases in the LRP group were (257.41±83.82) minutes and (180.18±44.77) minutes, respectively. There also was statistical difference between these two groups(P<0.01). The mean bleeding volume during operation, blood transfusions rate, pain score after operation.recovery time of intestinal function, the duration of catheterization.hospitalization stay after operation between LRP group and RRP group were (314.91±248.88)ml and (906.88±602.83)ml (P<0.01),16.67%and48.75%(P<0.01),3.01±1.46and4.29±1.17(P<0.05),(2.21±0.86)days and(2.93±1.27) days (P<0.01),(9.79±1.73) days and (15.28±4.91) days (P<0.01),(13.64±4.68)days and (18.08±7.00) days (P<0.05).In the LRP group, four cases of severe bleeding occurred, five cases of vesical triangle injury,one case of rectal injury,three cases of obturator nerve injury, three cases of peritoneum injury, thirteen cases of Urinary leakage, one cases of DVT,one cases of lymphatic cyst formation in pelvic cavity,the postoperative positive margin rate was19.33%. In the RRP group, seven cases of severe bleeding occurred,six cases of Urinary leakage, two cases of incision infection, five cases of DVT,the postoperative positive margin rate was21.25%.All150patients underwent LRP were followed up, the one-year biochemical recurrence rate was8.47%(10/118), the two-year biochemical recurrence rate was20.88%(19/91), the six-month continence rate was53.49%(69/129), the twelve-month continence rate was91.53%(108/118),66.7%(8/12) had restored the sexual function after nerve-sparing radical prostatectomy, four cases were dead. All80patients underwent RRP were followed up, the one-year biochemical recurrence rate was9.43%(5/53), the two-year biochemical recurrence rate was28.89%(13/45), the six-month continence rate was58.21%(39/67), the twelve-month continence rate was92.45%(49/53),60.0%(9/15) had restored the sexual function after nerve-sparing radical prostatectomy, one case was dead.CONCLUSIONSLaparoscopic radical prostatectomy not only perform better cosmetic results, less blood loss and faster recovery, but also offer equivalent oncological and functional results compared with open retropubic radical prostatectomy.LRP have the potential to be the gold standard in the treatment of localized prostate cancer.