Tags

Type your tag names separated by a space and hit enter

Bilateral vs unilateral laparoscopic intrafascial nerve-sparing radical prostatectomy: evaluation of surgical and functional outcomes in 457 patients.
BJU Int. 2011 Aug; 108(4):583-7.BI

Abstract

Study Type - Therapy (case series).

LEVEL OF EVIDENCE

4. What's known on the subject? and What does the study add? Bilateral nerve-sparing radical prostatectomy still represents an issue for urologists as the indications to perform it depend oft from the personal clinical experience. Moreover, until now data concerning bilateral and unilateral laparoscopic nerve-sparing radical prostatectomy have been limited. This study states that bilateral laparoscopic intrafascial nerve-sparing technique results in superior functional outcomes when compared with unilateral nsLRP and it suggests to prefer a bilateral nerve-sparing technique in younger patients with low-risk, organ-confined prostate cancer.

OBJECTIVE

To evaluate the surgical and functional outcomes in bilateral and unilateral nerve-sparing laparoscopic radical prostatectomy (nsLRP).

PATIENTS AND METHODS

Between January 2005 and May 2009, 457 nsLRP were performed at our clinic. In all, 250 patients underwent a bilateral nsLRP and 207 patients underwent an unilateral nsLRP. One surgeon performed all the operations. All patients presented at biopsy a localized prostate cancer. Demographic data and perioperative and postoperative measurements and outcomes were compared.

RESULTS

The operative times for bilateral nsLRP and unilateral nsLRP were 165 ± 45 min and 130 ± 25 min, respectively. The mean intra-operative blood loss was 450 ± 300 mL and 270 ± 160 mL in the bilateral and unilateral nsLRP groups with a transfusion rate of 3% and 1%, respectively (P = 0.013). Conversion to open surgery was never deemed necessary. Postoperatively, the mean Gleason Score after nsLRP and distribution of tumour stages was similar in the two groups, and the frequency of positive margins in both groups did not present any statistically significant difference. At 12 months, a complete continence was reported in 97% of patients who underwent a bilateral nsLRP and in 88% of patients of the unilateral nsLRP group. At that time, 69% in the bilateral nsLRP and 43% in the unilateral nsLRP groups reported the ability to engage in sexual intercourse.

CONCLUSION

The bilateral laparoscopic intrafascial nerve-sparing technique results in superior functional outcomes with regard to urinary continence and sexual potency, when compared with unilateral nsLRP, reporting similar oncological outcomes.

Authors+Show Affiliations

Department of Urology and Kidney Transplantation, Martin Luther University, Halle-Wittenberg, Germany. francesco.greco@medizin.unihalle.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

21091973

Citation

Greco, Francesco, et al. "Bilateral Vs Unilateral Laparoscopic Intrafascial Nerve-sparing Radical Prostatectomy: Evaluation of Surgical and Functional Outcomes in 457 Patients." BJU International, vol. 108, no. 4, 2011, pp. 583-7.
Greco F, Hoda MR, Wagner S, et al. Bilateral vs unilateral laparoscopic intrafascial nerve-sparing radical prostatectomy: evaluation of surgical and functional outcomes in 457 patients. BJU Int. 2011;108(4):583-7.
Greco, F., Hoda, M. R., Wagner, S., Reichelt, O., Inferrera, A., Magno, C., & Fornara, P. (2011). Bilateral vs unilateral laparoscopic intrafascial nerve-sparing radical prostatectomy: evaluation of surgical and functional outcomes in 457 patients. BJU International, 108(4), 583-7. https://doi.org/10.1111/j.1464-410X.2010.09836.x
Greco F, et al. Bilateral Vs Unilateral Laparoscopic Intrafascial Nerve-sparing Radical Prostatectomy: Evaluation of Surgical and Functional Outcomes in 457 Patients. BJU Int. 2011;108(4):583-7. PubMed PMID: 21091973.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bilateral vs unilateral laparoscopic intrafascial nerve-sparing radical prostatectomy: evaluation of surgical and functional outcomes in 457 patients. AU - Greco,Francesco, AU - Hoda,M Raschid, AU - Wagner,Sigrid, AU - Reichelt,Olaf, AU - Inferrera,Antonino, AU - Magno,Carlo, AU - Fornara,Paolo, Y1 - 2010/11/23/ PY - 2010/11/25/entrez PY - 2010/11/26/pubmed PY - 2011/10/14/medline SP - 583 EP - 7 JF - BJU international JO - BJU Int VL - 108 IS - 4 N2 - UNLABELLED: Study Type - Therapy (case series). LEVEL OF EVIDENCE: 4. What's known on the subject? and What does the study add? Bilateral nerve-sparing radical prostatectomy still represents an issue for urologists as the indications to perform it depend oft from the personal clinical experience. Moreover, until now data concerning bilateral and unilateral laparoscopic nerve-sparing radical prostatectomy have been limited. This study states that bilateral laparoscopic intrafascial nerve-sparing technique results in superior functional outcomes when compared with unilateral nsLRP and it suggests to prefer a bilateral nerve-sparing technique in younger patients with low-risk, organ-confined prostate cancer. OBJECTIVE: To evaluate the surgical and functional outcomes in bilateral and unilateral nerve-sparing laparoscopic radical prostatectomy (nsLRP). PATIENTS AND METHODS: Between January 2005 and May 2009, 457 nsLRP were performed at our clinic. In all, 250 patients underwent a bilateral nsLRP and 207 patients underwent an unilateral nsLRP. One surgeon performed all the operations. All patients presented at biopsy a localized prostate cancer. Demographic data and perioperative and postoperative measurements and outcomes were compared. RESULTS: The operative times for bilateral nsLRP and unilateral nsLRP were 165 ± 45 min and 130 ± 25 min, respectively. The mean intra-operative blood loss was 450 ± 300 mL and 270 ± 160 mL in the bilateral and unilateral nsLRP groups with a transfusion rate of 3% and 1%, respectively (P = 0.013). Conversion to open surgery was never deemed necessary. Postoperatively, the mean Gleason Score after nsLRP and distribution of tumour stages was similar in the two groups, and the frequency of positive margins in both groups did not present any statistically significant difference. At 12 months, a complete continence was reported in 97% of patients who underwent a bilateral nsLRP and in 88% of patients of the unilateral nsLRP group. At that time, 69% in the bilateral nsLRP and 43% in the unilateral nsLRP groups reported the ability to engage in sexual intercourse. CONCLUSION: The bilateral laparoscopic intrafascial nerve-sparing technique results in superior functional outcomes with regard to urinary continence and sexual potency, when compared with unilateral nsLRP, reporting similar oncological outcomes. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/21091973/Bilateral_vs_unilateral_laparoscopic_intrafascial_nerve_sparing_radical_prostatectomy:_evaluation_of_surgical_and_functional_outcomes_in_457_patients_ L2 - https://doi.org/10.1111/j.1464-410X.2010.09836.x DB - PRIME DP - Unbound Medicine ER -