Skip to main content
SpringerLink
Log in

Endoscopic extraperitoneal radical prostatectomy: the University of Leipzig experience of 1,300 cases

  • Topic Paper
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

We herein review our experience with endoscopic extraperitoneal radical prostatectomy (EERPE) as a first line therapy for localized prostate cancer. A series of 1,300 patients underwent EERPE (“wide excision”, standard nervesparing technique (nsEERPE), or intrafascial nsEERPE). The mean age of the patients was 63.3 years. Preoperative PSA mean value was 10.1 ng/ml. A total of 415 patients had undergone previous surgical procedure in the lower abdomen (n = 336) and prior surgery of the prostate (n = 79), respectively. The EERPE was employed in all cases without any specific selection criteria. Mean operative time was 153 (50–320) min. including lymphadenectomy with no conversion to open surgery. Seven intraoperative, 91 early and 4 late complications occurred. The transfusion rate was 0.9%. Positive surgical margins were found in 83 patients with pT2 stage (9.8%) and in 154 patients in pT3 stage (34.3%). The mean catheterization time was 6.2 days. The 12 month follow up indicated continence rate of 91.9% and potency rates of 34% in the unilateral nerve sparing group and 69.8% in the bilateral group. In the intrafascial nsEERPE group potency rates were 33.3% (unilateral) and 79.1% (bilateral) after 12 months. Postoperative positive surgical margins rate were 6.1% for pT2 and 20% for pT3 and the complications rate 4%. The results of this large series of 1,300 patients are promising. The recently introduced intrafascial nsEERPE further ameliorates the outcome of the procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Rassweiler J, Schulze M, Teber D, Seemann O, Frede T (2004) Laparoscopic radical prostatectomy: functional and oncological outcomes. Curr Opin Urol 14:75

    Article  PubMed  Google Scholar 

  2. Anastasiadis AG, Salomon L, Katz R, Hoznek A, Chopin D, Abbou C (2003) Radical retropubic versus laparoscopic prostatectomy a prospective comparison of functional outcome. Urology 62:292

    Article  PubMed  Google Scholar 

  3. Brown JA, Garlitz C, Gomella LG, Hubosky SG, Diamond SM, McGinnis D, Strup SE (2003) Pathologic comparison of laparoscopic versus open radical retropubic prostatectomy specimens. Urology 62:481

    Article  PubMed  Google Scholar 

  4. Guillonneau B, el-Fettouh H, Baumert H, Cathelineau X, Doublet JD, Fromont G, Vallancien G (2003) Laparoscopic radical prostatectomy: oncological evaluation after 1,000 cases at Montsouris Institute. J Urol 169:126

    Google Scholar 

  5. Steinberg AP, Gill IS (2004) Laparoscopic prostatectomy: a promising option in the treatment of prostate cancer. Cleve Clin J Med 71:78

    Article  Google Scholar 

  6. Vallancien G, Cathelineau X, Baumert H, Doublet JD, Guillonneau B (2002) Complications of transperitoneal laparoscopic surgery in urology: review of 1,311 procedures at a single center. J Urol 168:23

    Article  PubMed  CAS  Google Scholar 

  7. Guillonneau B, Rozet F, Cathelineau X, Lay F, Barret E, Doublet JD, Baumert H, Vallancien G (2002) Perioperative complications of laparoscopic radical prostatectomy: the Montsouris 3-year experience. J Urol 167:51

    Article  PubMed  Google Scholar 

  8. Stolzenburg JU, Do M, Rabenalt R, Pfeiffer H, Horn L, Truss MC, Jonas U, Dorschner W (2003) Endoscopic Extraperitoneal radical prostatectomy (EERPE)—initial experience after 70 procedures. J Urol 169:2066

    Article  PubMed  Google Scholar 

  9. Stolzenburg JU, Do M, Pfeiffer H, König F, Aedtner B, Dorschner W (2002) The endoscopic extraperitoneal radical prostatectomy (EERPE): technique and initial experience. World J Urol 20:48

    Article  PubMed  Google Scholar 

  10. Stolzenburg JU, Truss MC (2003) Technique of laparoscopic (endoscopic) radical prostatectomy. BJU Int 91:749

    Article  PubMed  Google Scholar 

  11. Stolzenburg JU, Truss MC, Do M, Rabenalt R, Pfeiffer H, Dunzinger M, Aedtner B, Stief CG, Jonas U, Dorschner W (2003) Evolution of endoscopic extraperitoneal radical prostatectomy (EERPE)—technical improvements and development of a nerve-sparing, potency-preserving approach. World J Urol 21:147

    Article  PubMed  Google Scholar 

  12. Rassweiler J, Seemann O, Schulze M, Teber D, Hatzinger M, Frede T (2003) Laparoscopic versus open radical prostatectomy: a comparative study at a single institution. J Urol 169:1689

    Article  PubMed  Google Scholar 

  13. Stolzenburg JU, Rabenalt R, Do M et al (2005) Endoscopic extraperitoneal radical prostatectomy (EERPE) oncolgical and functional results after 700 procedures. J Urol 174:1271–1275

    Article  PubMed  Google Scholar 

  14. Stolzenburg JU, Liatsikos E, Rabenalt R (2006) Nerve sparing endoscopic radical prostatectomy—effect of puboprostatic ligament preservation on early continence and positive margins. Eur Urol 49:103–112

    Article  PubMed  Google Scholar 

  15. Stolzenburg JU, Rabenalt R, Do M et al (2006) Nerve-sparing endoscopic extraperitoneal radical prostatectomy: University of Leipzig Technique. J Endourol 20:925–929

    Article  PubMed  Google Scholar 

  16. Stolzenburg JU, Rabenalt R, Tannapfel A, Liatsikos E (2006) Intrafascial nerve-sparing endoscopic radical prostatectomy. Urology 67:17–21

    Article  PubMed  Google Scholar 

  17. Stolzenburg JU, Rabenalt R, Do M, Horn LC, Liatsikos EN (2006) Modular training for residents with no prior experience with open pelvic surgery in endoscopic extraperitoneal radical prostatectomy. Eur Urol 49:491

    Article  PubMed  Google Scholar 

  18. Noldus J, Michl U, Graefen M et al (2002) Patient-reported sexual function after nerve-sparing retropubic radical prostatectomy. Eur Urol 42:118

    Article  PubMed  Google Scholar 

  19. Walsh PC (2000) Radical prostatectomy for localized prostate cancer provides durable cancer control with excellent quality of life: a structurated debate. J Urol 163:1802

    Article  PubMed  CAS  Google Scholar 

  20. Kundu SD, Roehl KA, Eggener SE, Antenor JAV, Han M, Catalona WJ (2004) Potency, continence and complications in 3477 consecutive radical retropubic prostatectomies. J Urol 172:2227

    Article  PubMed  Google Scholar 

  21. Rabbani F, Patel MI, Scardina PT (2004) Time course of recovery of potency after bilateral nerve sparing radical prostatectomy. J Urol 171(4 suppl):A1178

    Google Scholar 

  22. Guillonneau B, Rozet F, Barret E, Cathelineau X, Vallancien G (2001) Laparoscopic radical prostatectomy: assessment after 240 procedures. Urol Clin North Am 28:189

    PubMed  CAS  Google Scholar 

  23. Türk I, Deger IS, Winkelmann B, Roigas J, Schonberger B, Loening SA (2001) Laparoscopic radical prostatectomy. Experience with 145 interventions. Urol A 40:199

    Article  Google Scholar 

  24. Wieder JA, Soloway MS (1998) Incidence, etiology, location, prevention and treatment of positive surgical margins after radical prostatectomy for prostate cancer. J Urol 160:299

    Article  PubMed  CAS  Google Scholar 

  25. Eastham JA, Scardino PT (2002) Radical prostatectomy. In: Walsh Pc, Retik AB, Vaughan ED, Wein AJ (eds) Campbell´s urology, 8th edn, vol 4. Saunders, Philadelphia, pp 3080–3106

  26. Guillonneau B, Rozet F, Barret E, Cathelineau X, Vallancien G (2001) Laparoscopic radical prostatectomy: assessment after 240 procedures. Urol Clin North Am 28:189

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, University of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany

    Jens-Uwe Stolzenburg, Robert Rabenalt, Minh Do & Thilo Schwalenberg

  2. Department of Urology, Klinikum Dortmund, Dortmund, Germany

    Michael C. Truss

  3. Department of Urology, Medizinische Hochschule Hannover, Hannover, Germany

    Martin Burchardt & Thomas R. Herrmann

  4. Department of Urology, University of Patras, Patras, Greece

    Panagiotis Kallidonis & Evangelos N. Liatsikos

Authors
  1. Jens-Uwe Stolzenburg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert Rabenalt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Minh Do
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael C. Truss
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Martin Burchardt
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Thomas R. Herrmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Thilo Schwalenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Panagiotis Kallidonis
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Evangelos N. Liatsikos
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jens-Uwe Stolzenburg.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stolzenburg, JU., Rabenalt, R., Do, M. et al. Endoscopic extraperitoneal radical prostatectomy: the University of Leipzig experience of 1,300 cases. World J Urol 25, 45–51 (2007). https://doi.org/10.1007/s00345-007-0156-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-007-0156-9

Keywords

Search

Navigation