Comparison of Extraperitoneal Laparoscopic Radical
Prostatectomy and Open Retropubic Radical Prostatectomy
at Ramathibodi Hospital, Thailand: A Retrospective Review
Wisoot Kongcharoensombat MD*, Nakorn Tantirangsee MD*,
Suchart Chaimuangraj MD*, Chareon Leelanuphun MD*,
Wachira Kochakarn MD*, Suthep Patcharatrakul MD*
Affiliation :
* Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital,
Mahidol University, Bangkok, Thailand
Objective : To compare perioperative outcomes of open radical retropubic prostatectomies (O-RRP) and extraperitoneal
laparoscopic radical prostatectomies (E-LRP), focusing on operative time, blood loss, length of hospital stay, time to drain
removal, and surgical margin status.
Material and Method: The authors reviewed the medical histories of 173 patients treated for prostate cancer by radical
prostatectomy at Ramathibodi Hospital between January 1997 and August 2010. Eighty-one patients were treated with
O-RRP and 52 were treated with E-LRP. The remaining forty cases were omitted from the present study due to incomplete
data (such as incomplete operative note, history) or if the patient had post transurethral prostatectomy or post androgen
deprivation therapy. Open radical retropubic prostatectomies were performed by two experienced surgeons, and laparoscopic
extraperitoneal radical prostatectomies were performed by a single surgeon. The following data were collected and compared
between treatments, operative time, blood loss, length of hospital stay, time to drain removal, and surgical margin status.
Results : Preoperative patient data indicated that both groups were comparable in age, height, prostate-specific antigen
(PSA) levels, and Gleason scores from transurethral ultrasound guided biopsy. However, body weight and BMI was
significantly higher in the O-RRP group. Estimated blood loss was significantly lower in the E-LRP group (median = 600 ml,
range = 50-4,000 ml) than in the O-RRP group (median = 2,000 ml, range 200-7,500 ml) (p < 0.001). The length of hospital
stay in the E-LRP group (median = 8 days, range = 4-27 days) was significantly shorter than in the open group (median =
11 days, range = 5-37 days) (p < 0.001). There were no significant differences between operative times, times to drain
removal, or surgical margin statuses.
Conclusion : The present study shows that patients who underwent E-LRP experienced less blood loss and shorter hospital
stays than patients who underwent O-RRP.
Keywords : Laparoscopy, Prostatectomy, Extraperitoneal
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