Transvesical single-site laparoscopic radical prostatectomy of 39 cases: technique and clinical outcomes
10.3760/cma.j.issn.0529-5815.2016.10.006
- VernacularTitle:单孔经膀胱腹腔镜下前列腺癌根治术39例临床分析
- Author:
Donggen JIANG
1
;
Qunxiong HUANG
;
Jun PANG
;
Minhua LU
;
Xin GAO
Author Information
1. 中山大学附属第三医院泌尿外科
- Keywords:
Prostatic neoplasms;
Prostatectomy;
Urinary incontinence;
Erectile dysfunction
- From:
Chinese Journal of Surgery
2016;54(10):751-754
- CountryChina
- Language:Chinese
-
Abstract:
Objectives To present the surgical technique of transvesical single-site laparoscopic radical prostatectomy (TVSSLRP) and to evaluate its clinical efficacy.Methods The clinical parameters of 39 patients who underwent transvesical single-site laparoscopic radical prostatectomy in Department of Urology,Third Affiliated Hospital of Sun Yat-Sen University from November 2010 to June 2015 were retrospectively reviewed.The age was (M(QR)) 64 (10) years (range 47 to 70 years).The median preoperative serum total prostate specific antigen (PSA) level was 7.9 (2.9) μg/L (range 4.2 to 9.8 μg/L).The clinical TNM stage comprised 24 cases of cT1c and 15 cases of cT2a.All the transrectal biopsy Gleason score ≤6.The International Index of Erectile Function (IIEF-5) was (21.7 ± 1.6) points (range 18 to 24 points).The surgical procedures were performed through single-site transvesical approach.The postoperative serum PSA was regularly detected.The continence status were recorded at 1st month,3rd month and 6th month after catheter removal,and the potencies were evaluated at 3rd month,6th month and 12th month postoperative,respectively.Results All the operations were successfully performed and there was no intraoperative complication or conversion to standard laparoscopic approach.The operation duration was (105 ± 26) minuetes,the estimated blood loss was (100 ± 56) ml and no blood transfusion was required.The pathological TNM stage comprised 30 cases of pT2a and 9 cases of pT2b,the Gleason score all ≤6 and no patient had positive surgical margins.The duration of urinary catheterization was (11.6 ±1.4) days and hospital stay was (12.9 ±4.3) days.The continence rates were 84.6％,97.4％,100％ at 1st month,3rd month and 6th month after catheter removal,respectively.The potency rates were 48.7％,64.1％,76.9％ at 3rd month,6th month and 12th month postoperative,respectively,with an IIEF-5 score ≥18.Two cases demonstrated biochemical recurrence and one case presented vesico-urethral stricture during an average follow-up of 39 months (range 12 to 60 months).Conclusions TVSSLRP is suitable for lowrisk organ-confined prostate cancer.It can provide satisfactory continence and potency recovery,less complications and good oncological results.
