Mark William Louie-Johnsun1, Marcus M Handmer1, Ross John Spero Calopedos2, Charles Chabert3, Ronald J Cohen4, Troy R J Gianduzzo5, Paul A Kearns6, Daniel A Moon7, Jason Ooi8, Tom Shannon9, David Sofield10, Andrew H H Tan11. 1. Department of Urology, Gosford, Wyong and Gosford Private Hospitals and University of Newcastle, Gosford, NSW, Australia. 2. Department of Urology, Gosford, Wyong and Gosford Private Hospitals and University of Newcastle, Gosford, NSW, Australia. r.calopedos@gmail.com. 3. Department of Urology, Pindara Private Hospital, Benowa, Qld, Australia. 4. Department of Pathology, Uropath and University of Western Australia, Perth, WA, Australia. 5. Department of Urology, The Wesley Hospital, Brisbane, Qld, Australia. 6. Department of Urology, St John of God Hospital and University Hospital Barwon Health, Geelong, Vic., Australia. 7. Department of Urology, Epworth Healthcare, Melbourne, Vic., Australia. 8. Department of Urology, St Vincents Private Hospital, East Melbourne, Vic., Australia. 9. Department of Urology, Hollywood Private Hospital, Perth, WA, Australia. 10. Department of Urology, Bethesda Hospital, Perth, WA, Australia. 11. Department of Urology, Royal Perth Hospital, Perth, WA, Australia.
Abstract
OBJECTIVES: To analyse the Australian experience of high-volume Fellowship-trained Laparoscopic Radical Prostatectomy (LRP) surgeons. MATERIALS AND METHODS: 2943 LRP cases were performed by nine Australian surgeons. The inclusion criteria were a prospectively collected database with a minimum of 100 consecutive LRP cases. The surgeons' LRP experience commenced at various times from July 2003 to September 2009. Data were analysed for demographic, peri-operative, oncological and functional outcomes. RESULTS: The mean age of patients were 61.5 years and mean preoperative PSA 7.4 ng/ml. Mean operating time was 168 minutes with conversion to open surgery in 0.5% and a blood transfusion rate of 1.1%. Overall mean length of stay was 2.5 days. 73.6% of pathological specimens were pT2 and 86.3% had Gleason Score >7. Overall positive surgical margins (PSM) occurred in 15.9% with pT2 PSM 9.8%, pT3a PSM 30.8% and pT3b PSM 39.2%. Mean urinary continence at 12 months was 91.4% (data available from five surgeons). Mean 12 months potency after bilateral nerve spare was 47.2% (data available from four surgeons). Biochemical recurrence occurred in 10.6% (mean follow up 17 months). CONCLUSION: The Australian experience of Fellowship trained surgeons performing LRP demonstrates favourable peri-operative, oncological and functional outcomes in comparison to published data for open, laparoscopic and robotic assisted radical prostatectomy. In our Australian centres, LRP remains an acceptable minimally invasive surgical treatment for prostate cancer despite the increasing use of robotic assisted surgery.
OBJECTIVES: To analyse the Australian experience of high-volume Fellowship-trained Laparoscopic Radical Prostatectomy (LRP) surgeons. MATERIALS AND METHODS: 2943 LRP cases were performed by nine Australian surgeons. The inclusion criteria were a prospectively collected database with a minimum of 100 consecutive LRP cases. The surgeons' LRP experience commenced at various times from July 2003 to September 2009. Data were analysed for demographic, peri-operative, oncological and functional outcomes. RESULTS: The mean age of patients were 61.5 years and mean preoperative PSA 7.4 ng/ml. Mean operating time was 168 minutes with conversion to open surgery in 0.5% and a blood transfusion rate of 1.1%. Overall mean length of stay was 2.5 days. 73.6% of pathological specimens were pT2 and 86.3% had Gleason Score >7. Overall positive surgical margins (PSM) occurred in 15.9% with pT2 PSM 9.8%, pT3a PSM 30.8% and pT3b PSM 39.2%. Mean urinary continence at 12 months was 91.4% (data available from five surgeons). Mean 12 months potency after bilateral nerve spare was 47.2% (data available from four surgeons). Biochemical recurrence occurred in 10.6% (mean follow up 17 months). CONCLUSION: The Australian experience of Fellowship trained surgeons performing LRP demonstrates favourable peri-operative, oncological and functional outcomes in comparison to published data for open, laparoscopic and robotic assisted radical prostatectomy. In our Australian centres, LRP remains an acceptable minimally invasive surgical treatment for prostate cancer despite the increasing use of robotic assisted surgery.
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