Is Laparoscopic Radical Prostatectomy after Transurethral Prostatectomy Appropriated?
Sunai Leewansangtong MD*, Tawatchai Taweemonkongsap MD*
Affiliation : * Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University
Objective : To evaluate the appropriateness and morbidity of laparoscopic radical prostatectomy (LRP) in
patients who had previous trans urethral prostatectomy (TURP).
Materials and Methods : From February 2005 to February 2006, 27 patients with clinical localized prostate
cancer underwent LRP with the same technique by a single surgeon. Nineteen patients were diagnosed with
trans rectal ultrasound guided biopsy (TRUSBX) and eight patients were diagnosed with TURP. Operative
data and pathological outcomes were evaluated between the two group.
Results : Mean operative time and blood loss in TURSBX group were 233 minutes and 610 ml while those in
TURP group were 251 minutes and 812 ml, respectively. These were not significantly different (all p valve >
0.1). There was no significant complication or mortality in either groups. LRP could achieve high free margin
rate. Of 19 patients with pathological localized disease, 17 (89.4%) had free margin. It was found in12 of 14
patients (85.7%) in TRUSBX group and in all patients in the TURP group.
Conclusion : LRP is appropriate to undergo in prostate cancer patients with previous TURP. LRP after TURP
did not have a higher morbidity than LRP after TRUSBX and did not compromise free margin rate.
Keywords : Prostate, Prostatic carcinoma, Laparoscopic radical prostatectomy
