Hong Kong Med J 2008;14:192-7 | Number 3, June 2008
Laparoscopic radical prostatectomy: single centre experience after 5 years
Steven WH Chan, KM Lam, SC Kwok, C Yu, WH Au, YP Yung, Ida SF Mah, Peggy SK Chu, CW Man
Division of Urology, Department of Surgery, Tuen Mun Hospital, Tuen Mun, Hong Kong
OBJECTIVE. To summarise our experience of laparoscopic radical prostatectomy in a single centre in Hong Kong over 5 years.
DESIGN. Retrospective study.
SETTING. Urology Division, Department of Surgery, Tuen Mun Hospital, Hong Kong.
PATIENTS. A total of 87 patients who underwent laparoscopic radical prostatectomy from March 2002 to May 2007.
MAIN OUTCOME MEASURES. Peri-operative data and follow-up information.
RESULTS. The operative procedure used entailed Montsouris technique and its modifications, including the latest method involving the extraperitoneal descending technique. In all, 87 patients underwent the operation; in two, the procedure was converted to open surgery. Peri-operative parameters which showed improvement included: operating time, blood loss, resort to blood transfusions, and the complication rate. There was no operation-related mortality. In organ-confined disease, a clear surgical margin was achieved in 93% of the patients, but in those whose disease was not organ-confined, the positive margin rate was 87%. Among patients with organ-confined disease, 13% had evidence of biochemical recurrence. Hormonal therapy was started in five patients, none of whom died during the follow-up period (mean, 24 months). Continence recovered in 69% of the patients by 6 months and in 92% by 12 months post-surgery. Assessment of erectile function before and after the surgery was problematic and estimated to be 20% among patients having the nerve-sparing procedure performed.
CONCLUSION. Although Hong Kong has a relatively low incidence for prostate cancer, it was possible to develop laparoscopic radical prostatectomy with acceptable early results. Further follow-up is warranted before formulating definitive conclusions about this procedure.
Key words: Laparoscopy; Postoperative complications; Prostatectomy; Prostatic neoplasms; Treatment outcome
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