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See Latest ArticlesRadical laparoscopic salvage prostatectomy: medium-term functional and oncological results
Journal of Endourology, 07/20/09
Nunez-Mora C et al. - In a trial to analyze the surgical, functional, and oncological results of radical laparoscopic salvage prostatectomy in local postradiotherapy recurrence, it was conlcuded that radical laparoscopic salvage prostatectomy is a complex technique that seems to allow attaining high and long-lasting rates of biochemical remission in pts with local postradiotherapy recurrence. Although there is less morbidity in this series vs the anastomotic stenosis and rectal injuries rate published in radical retropubic salvage prostatectomy, more extensive comparative studies are required to confirm this fact.
Methods- 9 pts were treated with radical laparoscopic salvage prostatectomy.
- 5 pts had received prior treatment with brachytherapy and 4 with external radiotherapy.
- Average age of pts was 59.3 yrs.
- Average preoperative prostate-specific antigen was 9.1 ng/mL.
- Average follow-up period was 26.8 mos.
- Average duration of surgery was 170 mins.
- There was no need to resort to open surgery or transfusions.
- There were no cases of rectal injuries.
- 4 cases were pT2c, 1 pT3a, 3 pT3b, and 1 pT4a.
- Gleason score was 7 in 3 cases, 8 in 2 cases, and 9 in another 4.
- 2 pts had nodal metastasis.
- Postoperative prostate-specific antigen was undetectable in 7 of 9 pts.
- 2 pts experienced biochemical recurrence 16 and 13 mos after surgery.
- After a minimum follow-up period of 15 mos, they were free from recurrence.
- There were no cases of urethrovesical anastomotic stenosis.
- 3 pts manifested severe incontinence (>2 diapers per day), which was corrected in 2 cases by implanting an artificial sphincter.
- The other 6 pts required 0 to 1 pads/day.
- Before surgery, only 1 of the 5 potential pts maintained his erectile function.
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