Laparoscopic radical prostatectomy : follow-up after 1000 cases

Introduction: Laparoscopic radical prostatectomy is an evolvingtechnique with promising results for patients on the oncological,functional and recovery time stand-points. This review summarisesthe experience of laparoscopic radical prostatectomy at the InstitutMutualiste Montsouris since 1998.Material and methods : Four surgeons performed 1000 laparoscopicradical prostatectomies trans-peritoneally, between January1998 and January 2002. Mean patient age was 63 +/- 6,2 years.Clinical stages were T1 and T2 in 669 and 331 respectively. Meanpreoperative PSA was 10 +/- 6.1 ng/mL. Mean Gleason score was6 +/- 1. Mean prostate weight was 58.4 +/- 23.2 g.Results: Mean operative time was 200 minutes. Mean blood losswas 380 mL. Pathological stages were pT2a, pT2b, pT3a, pT3b,pT1-3 N1 in 203, 572, 142, 77 and 6 respectively. Positive surgicalmargin rate was 18%. Biochemical failures occurred in 9% of patientsafter 1 year - follow-up. Recovery of potency and continenceresults were encouraging. Mean hospital stay was 5.8 days. Majorcomplications consisting mainly of rectal tears occurred in 10 patients.Conclusion: Laparoscopic radical prostatectomy is a feasible operationwhen performed by a trained team. Mid-term oncologicalresults are comparable to open surgery. Functional results are promising.Long term follow-up is needed to confirm our assumption.