Transperitoneal or extraperitoneal approach for laparoscopic radical prostatectomy: a false debate over a real challenge

J Urol. 2004 Feb;171(2 Pt 1):714-6. doi: 10.1097/01.ju.0000103885.71434.02.

Abstract

Purpose: With our extensive experience of transperitoneal laparoscopic prostatectomy, we evaluated the advantages and disadvantages of the extraperitoneal approach by comparing 2 consecutive series of each procedure.

Materials and methods: We reviewed 200 consecutive procedures performed by 2 surgeons. A total of 100 transperitoneal procedures (designated group 1) were compared to the first 100 extraperitoneal cases (designated group 2).

Results: Mean operating time was 173 minutes in group 1 and shorter in group 2 at 163 minutes (p = 0.003). Mean blood loss (360 ml in group 1,375 ml in group 2) and transfusion rates (4% in group 1, 3% in group 2) were equivalent. There were no major complications. Minor complications were 10% in group 1 and 9% in group 2. There was no statistical difference in positive margin rate between groups 1 and 2.

Conclusions: The 2 procedures are equivalent in terms of operative, postoperative and pathological data. Each surgeon has to choose considering personal experience, training and standardization.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / surgery*
  • Aged
  • Humans
  • Laparoscopy*
  • Male
  • Middle Aged
  • Peritoneum
  • Prostatectomy / methods*
  • Prostatic Neoplasms / surgery*