Laparoscopic radical prostatectomy: perioperative complications in an initial series of 50 cases
Article published in Urologia Polska 2006/59/2.

authors

Tomasz Szydełko, Jarosław Kasprzak, Paweł Kowal, Bartosz Małkiewicz, Tadeusz Niezgoda, Janusz Dembowski, Anna Kołodziej, Romuald Zdrojowy, Jerzy Lorenz: Katedra i Klinika Urologii i Onkologii Urologicznej Akademii Medycznej we Wrocławiu

keywords

prostate, prostate cancer, laparoscopic radical prostatectomy, complications

summary

The aim of the study. The objective of the research is to evaluate perioperative complications following laparoscopic radical prostatectomy in patients with prostate cancer.

Material and method. Over the period of two years from May 2003 to May 2005, 50 laparoscopic radical prostatectomies were performed. For forty surgeries transperitoneal access was used; for the remaining 10 operations retroperitoneal access was chosen. Lymph nodes were removed if the PSA level exceeded 15 ng/ml and/or if Gleason score was 7 or above. The time of operation varied from 210 to 540 minutes. Only one patient needed blood transfusion after the surgery.

Results. Open conversion was necessary in one patient. In one case the bladder got perforated. In two cases the rectum was injured. As the injury to the coecum was not noticed intra-operatively, peritonitis developed. In one patient, the bilateral hydronephrosis was observed in the post-operative period. Yet it got back to normal once a Foley's catether was removed. In 7 patients intra-peritoneal leakage was observed as the anastomosis was not water-tight. In 6 cases temperature rose above 38 degrees C and remained high for 3 or more days after the surgery.

Conclusions. Laparoscopic radical prostatectomy is a difficult operation. It demands skill and experience in laparoscopy. However, the number of reported complications is relatively low.

references

Schuessler WW, Schulam PG, Clayman RV, Kavoussi LR: Laparoscopic radical prostatectomy: Initial short term experience. Urology 1997, 50, 854-857.
Vallancien G, Guillonneau B, Fournier G et al: Laparoscopic Radical Prostatectomy. Ecole Europeenne de Chirurgie Collection. 2002, 19-96.
Guillonneau B, Vallancien G: Laparoscopic radical prostatectomy: the Montsouris technique. J Urol 2000, 163, 1643-1649.
Bollens R, Vanden Bossche M, Roumeguere Th et al: Extraperitoneal Laparoscopic Radical Prostatectomy. Results after 50 Cases. Eur Urol 2001, 40, 65-69.
Arai Y, Egawa S, Terachi T et al: Morbidity of laparoscopic radical prostatectomy: summary of early multi-institutional experience in Japan. Int J Urol 2003, 10 (8), 430-434.
Eden CG, Cahill D, Vass JA et al: Laparoscopic radical prostatectomy: the initial UK series. BJU Int 2002, 90 (9), 876-882.
Rassweiler J, Senkter L, Seemann O et al: Heilbronn Laparoscopic Radical Prostatectomy. Technique and Results after 100 Cases. Eur Urol 2001, 40, 54-64.
Guillonneau B, Rozet F, Barret E: Laparoscopic radical prostatectomy: Assessment after 240 procedures. Urol Clin N Amer 2001, 28, 1, 189-202.
Rehman J, Ragab MM, Venkatesh R et al: Laparoscopic radical prostatectomy: Washingtom University initial experience and prospective evaluation of quality of life. J Endourol 2004, 18 (3), 277-287.
Abbou CC, Salomon L, Hoznek A et al: Laparoscopic radical prostatectomy: preliminary results. Urology 2000, 55 (5), 630-634.
Tuerk I, Deger S, Winkelmann B et al: Laparoscopic radical prostectomy. Technical Aspects and Experience with 125 Cases. Eur Urol 2001, 40, 46-53.
Katz R, Borkowski T, Hoznek A et al: Operative management of rectal injuries during laparoscopic radical prostatectomy. Urology 2003, 62 (2), 310-313.
Guillonneau B, Gupta R, El Fettouh H et al: Laparoscopic management of rectal injury during laparoscopic radical prostatectomy. J Urol 2003, 169 (5), 1694-1696.

correspondence