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The Australian laparoscopic non robotic radical prostatectomy experience – analysis of 2943 cases ( USANZ supplement)
Author(s) -
LouieJohnsun Mark William,
Handmer Marcus M.,
Calopedos Ross John Spero,
Chabert Charles,
Cohen Ronald J.,
Gianduzzo Troy R. J.,
Kearns Paul A.,
Moon Daniel A.,
Ooi Jason,
Shan Tom,
Sofield David,
Tan Andrew H. H.
Publication year - 2016
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13610
Subject(s) - medicine , prostatectomy , urinary continence , laparoscopic radical prostatectomy , surgery , prostate cancer , blood loss , urology , robotic surgery , general surgery , cancer
Objectives To analyse the Australian experience of high‐volume Fellowship‐trained Laparoscopic Radical Prostatectomy ( LRP ) surgeons. Materials and Methods 2943 LRP cases were performed by nine Australian surgeons. The inclusion criteria were a prospectively collected database with a minimum of 100 consecutive LRP cases. The surgeons’ LRP experience commenced at various times from July 2003 to September 2009. Data were analysed for demographic, peri‐operative, oncological and functional outcomes. Results The mean age of patients were 61.5 years and mean preoperative PSA 7.4 ng/ml. Mean operating time was 168 minutes with conversion to open surgery in 0.5% and a blood transfusion rate of 1.1%. Overall mean length of stay was 2.5 days. 73.6% of pathological specimens were pT 2 and 86.3% had Gleason Score >7. Overall positive surgical margins ( PSM ) occurred in 15.9% with pT 2 PSM 9.8%, pT 3a PSM 30.8% and pT 3b PSM 39.2%. Mean urinary continence at 12 months was 91.4% (data available from five surgeons). Mean 12 months potency after bilateral nerve spare was 47.2% (data available from four surgeons). Biochemical recurrence occurred in 10.6% (mean follow up 17 months). Conclusion The Australian experience of Fellowship trained surgeons performing LRP demonstrates favourable peri‐operative, oncological and functional outcomes in comparison to published data for open, laparoscopic and robotic assisted radical prostatectomy. In our Australian centres, LRP remains an acceptable minimally invasive surgical treatment for prostate cancer despite the increasing use of robotic assisted surgery.