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Comparison among endoscopic radical prostatectomy during the learning period Tetsuya FUJIMURA 1 , Hiroshi FUKUHARA 1 , Daisuke YAMADA 1 , Motofumi SUZUKI 1 , Yutaka ENOMOTO 1 , Hiroaki NISHIMATSU 1 , Haruki KUME 1 , Yukio HOMMA 1 1Department of Urology, Graduate School of Medicine, The University of Tokyo Keyword: 前立腺癌 , 低侵襲手術 , ロボット支援手術 pp.189-197
Published Date 2013/3/15
DOI https://doi.org/10.11477/mf.4426100922
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Minimum incision endoscopic surgery (MIES), laparoscopic radical prostatectomy (LRP), and robot-assisted radical prostatectomy (RARP) performed for the treatments of localized prostate cancer are covered by national insurance in Japan. We compared the outcome of the three surgeries during the learning period. A total of thirty-two patients with localized prostate cancer were enrolled in this study. The distribution of patients who underwent radical prostatectomy using the three procedures was as follows: MIES 10 patients, LRP 11 patients, and RARP 11 patients. Furthermore, patients in each group were divided into low-, intermediate-, and high-risk patients according to the D'Amico criteria as follows: 2, 4, and 4 patients in MIES group; 3, 8, and 0 patients in LRP group; 1, 8, and 2 patients in RARP group. The average operating time was 214 minutes for MIES, 355 minutes for LRP, and 321 minutes for RARP. The average operating time for MIES was significantly shorter than that for the other surgeries. The average blood loss (ml) was 1,516, 1,327, and 247 for MIES, LRP, and RARP, respectively. The average blood loss in RARP was significantly lower than that in the other two surgeries. In addition, positive surgical margin rate in pT2 stage was 2/6 (33.3%) for MIES, 2/7 (28.5%) for LRP, and 1/9 (11.1) for RARP. Therefore, RARP was found to be more favorable technique, achieving decreased blood loss and good results for radical surgical treatment even during the learning period.


Copyright © 2013, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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