Options In Prostate Cancer Surgery: Perineal Prostatectomy In The Age Of Minimally Invasive Surgery

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Cancer / Oncology
Article Date: 11 Aug 2008 - 0:00 PDT

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UroToday.com - In the age of minimally invasive surgery, laparoscopic and robotic assisted laparoscopic prostatectomy has been associated with a substantial increase in operative costs without a significant improvement in outcomes to date. As a result, there has been renewed interest in one of the original approaches to prostate cancer. In this presentation we compare the MUSC experience with perineal prostatectomy (RPP) to published results using laparoscopic and robot-assisted laparoscopic prostatectomy (LRP, RALP).

Our experience with over 300 consecutive perineal prostatectomies is presented and operative technique reviewed in detail. Issues such as hospital stay, intra-operative blood loss, length of catheterization, complications, both long and short term, and outcomes will be reviewed. Selective indications for a perineal prostatectomy will be defined and discussed.

The mean operative time for RPP was less than that for LRP or RALP. Estimated blood loss was equivalent for RPP and RALP and less than that for LRP. Length of catheterization in the RPP group was longer but was based on a care map and has been modified to 7 days without problems in the last 75 pts. Length of hospital stay was equivalent for all techniques and hospital costs were significantly less for RPP vs. the alternatives.

A detailed discussion of the current evidence and its quality concerning the various approaches will be undertaken and the audience should have a clear understanding of the current issues at the end of the presentation.

Presented by: Thomas Keane, MD, at the Masters in Urology Meeting - July 31, 2008 - August 2, 2008 - Elbow Beach Resort, Bermuda

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