Laparoscopic radical prostatectomy technical aspects and experience with 100 cases in Rajavithi Hospital

To determine technical aspects, preoperative data and perioperative outcomes in 100 cases of Laparoscopic Radical Prostatectomy (LRP) in Rajavithi Hospital. Retrospective study from October 2005 to January 2010, the first 100 consecutive patients who underwent LRP by the same surgeon were assessed in Rajavithi Hospital. Mean age, clinical stage, preoperative PSA level, Gleason score, operative time, estimated blood loss, perioperative complications, pathological stage and margin status were recorded and analyzed. Statistical analysis is shown in median (Q1-Q3), means +/- SD. The mean age was 67.9 +/- 6.5 years and preoperative PSA was 19.28 (0.39-105.10) ng/dl. The most clinical stage was T1c (64.8%), Median operation time was 425 (360-600) minutes and blood loss was 1,400 (800-2,475) ml. Laparoscopic bilateral pelvic lymph node dissection was 60 cases and pathologic positive lymph node was 8 cases (13%). The positive surgical margin rate was 21.6%. There were 28 post-operative complications: urine leakage more than 2 weeks (11 cases), rectal injury (10 cases), hematoma (3 cases), lymphatic leakage more than 2 week (3 cases), DVT (1 cases). Median catheter time was 7 (6-25) days. Laparoscopic radical prostatectomy is a feasible option for the surgical treatment of localized prostate cancer LRP can help improve vision and outcome of pelvic surgery which depends on clinical stage and learning curve.