Comparing Laparoscopic And Open Radical Prostatectomy

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Cancer / Oncology
Article Date: 05 Jul 2008 - 0:00 PDT

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ORLANDO, FL (UroToday.com) - (Reported from the Annual Meeting of the American Urological Association) Abstract 996 and 1001 compared laparoscopic and open radical prostatectomy. There was little to no difference in blood loss, hospital stay, continence, and potency. The 5-year disease-free survival rates for laparoscopic radical prostatectomy are shown below.

Overall: 79%
Low-risk: 92%
Intermediate: 77%
High: 65%
Positive Margins: 12.5%
Positive lymph nodes (standard dissection): 3%
Positive lymph nodes (extended dissection): 10%

The warm ischemia time is higher in laparoscopic partial nephrectomy compared to open. A warm ischemia time of more than 35-40 minutes leads to renal dysfunction.

Use of erythropoietin (EPO) provided superior renal protection compared to mannitol in a canine model. EPO almost completely abrogated the renal dysfunction caused by warm ischemia.

Laparoscopic cryotherapy for renal masses seemed superior to radiofrequency ablation regarding local recurrence rates and need for repeat treatment. The cancer-specific survival for cryotherapy at 5 years is 95% and 88% at 10 years.

ABST# 996: Functional and Oncologic Outcomes of Laparoscopic versus Robotic Assisted Radical Prostatectomy: Contemporary Single Surgeon Experience
A. Ari Hakimi, MD, et al.

ABST #1001: Single Surgeon Comparison Between Conventional Laparoscopic and Robot-Assisted Radical Prostatectomy: Pathological and Functional Outcomes
Mark L. Gonzalgo, MD, et al.

Presented by David Hoenig, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor David P. Wood, MD

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