Laparoscopic Radical Prostatectomy: Transperitoneal Laparoscopic Radical Prostatectomy versus Extraperitoneal Endoscopic Radical Prostatectomy
Kittipong Phinthusophon MD*, Chaiyong Nualyong MD*, Sittiporn Srinualnad MD*, Tawatchai Taweemonkongsap MD*, Teerapon Amornvesukij MD*
Affiliation : * Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Objective : To compare the perioperative results between Transperitoneal Laparoscopic Radical Prostatectomy
(T-LRP) and Extraperitoneal Endoscopic Radical Prostatectomy (E-LRP).
Materials and Methods : Retrospective reviews of 125 patients who underwent laparoscopic radical prostatec-
tomy by single surgeon (C.N) for stage T2-T3 adenocarcinoma of the prostate between May 2001 and July
2006 at Siriraj Hospital. Fifty-six cases had T-LRP and 69 cases had E-LRP. The preoperative data (age,
presenting PSA, and Gleason score), perioperative data (prostatic weight, operative time, intraoperative
blood loss, the day of full oral diet, length of drain, and catheter time), pathologic stage, and margin status
were compared.
Results : Mean age and Gleason score were comparable in both groups. Mean presenting PSA was lower in
T-LRP (9.93) as compared to E-LRP (21.84) (p = 0.046). The mean prostatic weight was comparable in both
T-LRP and E-LRP. The mean operative time of T-LRP (350) was significant longer than E-LRP (220) (p < 0.001).
Mean intraoperative blood loss was more in T-LRP (883) as compared to E-LRP (605) (p = 0.001). Average
blood transfusion was higher in T-LRP (1.23 unit) as compared to E-LRP (0.32). Postoperative full oral diet,
length of drain, and catheter time in E-LRP were shorter than T-LRP (full diet: median 2 days vs. 3 days, p =
0.001) (length of drain: 4.98 days vs. 6.69 days, p = 0.002) (Catheter time: 8.9 days vs. 11.9 days, p = 0.002).
Margin status were comparable in both groups but mean postoperative Gleason score was higher in E-LRP as
compared to T-LRP (7.2 vs. 6.85, p = 0.022).
Conclusions : E-LRP resulted in significant less operative time, intraoperative blood loss, postoperative oral
diet, length of drain and catheter time where as the pathological margin status was the same in both T-LRP
and E-LRP.
Keywords : Laparoscopic, Prostatectomy, Compare
