Laparoscopic Radical Prostatectomy: Perioperative Outcomes and Morbidity of 559 Consecutive Cases in Siriraj Hospital, Thailand
Buncha Thiptirapong MD*, Sunai Leewansangtong MD*, Chaiyong Nualyong MD*, Sittiporn Srinualnad MD*, Tawatchai Taweemonkongsap MD*, Bansithi Chaiyaprasithi MD*, Teeraporn Amornvesukit MD*, Kittipong Phinthusophon MD*, Siros Jitpraphai MD*, Phisaiphun Wattayang MD*, Phichaya Sujijantararat MD*, Suchai Soontrapa MD*
Affiliation : * Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To evaluate perioperative outcomes and morbidity of laparoscopic radical prostatectomy in Siriraj Hospital
during a 5-year experience.
Material and Method: Five hundred fifty nine patients who underwent laparoscopic radical prostatectomy (LRP) by seven
surgeons at Siriraj Hospital between September 2004 and September 2009 were included in the study. Data of perioperative
results and postoperative parameters were retrospectively evaluated.
Results : Mean operative time was 257 minutes SD 75 (range 125 to 680 min). The mean operative time of the first 100 cases
was significantly higher than of the last 100 cases (307 ml/min SD 95 versus 223 ml/min SD 56; p-value = 0.001). Mean
estimated blood loss was 779 ml SD 607 (range 40 to 6,000 ml). Of 559 patients, 148 patients (26.5%) had blood transfusions.
The blood transfusion rate in the first 100 cases was significantly higher than those of the last 100 cases (36.5% versus 15%;
p-value = 0.016). The median duration of catheterization time was 8 days. The mean time of drain insertion was 4.2 days
SD 1.8 (range 2 to 18 days) postoperatively. Hospital stay was 8.8 days SD 7.6 (range 3 to 149 days). Overall perioperative
complications rate was 17.1%. Of these patients, 13.4% were minor complication (Clavien 1, 2) and 3.7% were major
complication (Clavien 3, 4). There were no mortalities. Late complication rate was 2.1%, which most of them were stricture
of anastomosis.
Conclusion : Perioperative outcomes and morbidity of LRP in a 5-year period were acceptable. Laparoscopic radical
prostatectomy is technically demanding with an initially longer operative time and higher blood transfusion rate. The learning
curve of the surgical team is needed to achieve good results.
Keywords : Laparoscopic, Radical prostatectomy
