To determine the oncologic and functional outcomes of ELRP on a single surgical team’s series.
A total of 1,600 consecutive ELRP patients were recorded with a 2-year follow-up. In 778 patients, a 5-year follow-up was available.
The mean operative time was 125,6 min (PLND not included) and 150,9 min (PLND included). Postoperative stage was pT2a in 282 patients (17.6 %), pT2b in 877 (54.8 %), pT2c in 18 (1.1 %), pT3a in 241 (15 %), and pT3b in 182 (11.3 %). Positive margins were detected in 7.4 and 13.4 % of pT2 and pT3 tumors, respectively. Overall complication rate was 4 %. PSA levels resulted in <0.2 ng/mL in 96.4, 94.9, 92, 90.9, and 81.5 % of the cases at 3, 12, 24, 36, and 60 months after surgery, respectively. BCRFS rates 5 years after ELRP were 88.7 % for patients staged as pT2, 73.9 % for pT3a, and 62.4 % for pT3b. Complete urinary continence rate resulted in 39 and 92 % after 1 and 12 months, respectively, with a further increase from 92 to 98.4 % at 24-month follow-up. A nerve-sparing procedure was performed in 45 % of patients. The overall potency rate at 12-month follow-up was 38.67 % for UNSS patients and 75 % for BNSS patients. Potency recovery was age-dependent, with patients aged <55 years who resulted potent in 46.8 % of UNSS and 95.8 % of BNSS after 24 months.
ELRP is a standardized and safe procedure that implies advantages of both minimally invasive and extraperitoneal approaches with elevated standards for oncologic and functional outcomes obtained at long-term follow-up.
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Schuessler WW, Shulam PG, Clayman RV et al (1997) Laparoscopic radical prostatectomy: initial short term experience. Urology 50:854–857
Raboy A, Ferzli G, Albert P (1997) Initial experience with extraperitoneal endoscopic radical retropubic prostatectomy. Urology 50:849–853
Guillonneau B, Cathelineau X, Barret E, Rozet F, Val-lancien G (1999) Laparoscopic radical prostatectomy: technical and early oncological assessment of 40 operations. Eur Urol 36:14–20
Guillonneau B, El-Fettouh H, Baumert H et al (2003) Laparoscopic radical prostatectomy: oncological evaluation after 1,000 cases at Montsouris Institute. J Urol 169:1261–1266
Kowalczyk KJ, Yu H, Ulmer W et al (2012) Outcomes assessment in men undergoing open retropubic radical prostatectomy, laparoscopic radical prostatectomy, and robotic-assisted radical prostatectomy. World J Urol 30(1):85–89
Salomon L, Levrel O, de la Taille A et al (2002) Radical prostatectomy by the retropubic, perineal and laparoscopic approach: 12 years of experience in one center. Eur Urol 42:104–110
Bollens R, Vanden Bossche M, Roumeguere T, Damoun A, Ekane S, Hoffmann P, Zlotta AR, Schulman CC (2001) Extraperitoneal laparoscopic radical prostatectomy. Results after 50 cases. Eur Urol 40(1):65–69
Rassweiler J, Stolzenburg J, Sulser T, Deger S, Zumbé J, Hofmockel G et al (2006) Laparoscopic radical prostatectomy—the experience of the German Laparoscopic Working Group. Eur Urol 49:113–119
Touijer K, Guillonneau B (2006) Laparoscopic radical prostatectomy: a critical analysis of surgical quality. Eur Urol 49(4):625–632
Hoznek A, Salomon L, Olsson LE, Antiphon P, Saint F, Cicco A, Chopin D, Abbou CC (2001) Laparoscopic radical prostatectomy. The Créteil experience. Eur Urol 40(1):38–45
Martina GR, Giumelli P, Scuzzarella S, Remotti M, Caruso G, Lovisolo J (2005) Laparoscopic extraperitoneal radical prostatectomy—learning curve of a laparoscopy-naive urologist in a community hospital. Urology 65(5):959–963
Rozet F, Galiano M, Cathelineau X, Barret E, Cathala N, Vallancien G (2005) Extraperitoneal laparoscopic radical prostatectomy: a prospective evaluation of 600 cases. J Urol 174:908–911
Stolzenburg JU, Rabenalt R, Do M, Truss MC, Burchardt M, Herrmann TR, Schwalenberg T, Kallidonis P, Liatsikos EN (2007) Endoscopic extraperitoneal radical prostatectomy: the University of Leipzig experience of 1,300 cases. World J Urol 25(1):45–51
Stolzenburg JU, Rabenalt R, DO M, Ho K, Dorschner W, Waldkirch E, Jonas U, Schütz A, Horn L, Truss MC (2005) Endoscopic extraperitoneal radical prostatectomy: oncological and functional results after 700 procedures. J Urol 174(4Pt 1):1271–1275
Paul A, Ploussard G, Nicolaiew N, Xylinas E, Gillion N, de la Taille A, Vordos D, Hoznek A, Yiou R, Abbou CC, Salomon L (2010) Oncologic outcome after extraperitoneal laparoscopic radical prostatectomy: midterm follow-up of 1,115 procedures. Eur Urol 57(2):267–272
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
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
Herrmann TR, Rabenalt R, Stolzenburg JU et al (2007) Oncological and functional results of open, robot-assisted and laparoscopic radical prostatectomy: does surgical approach and surgical experience matter? World J Urol 25:149–160
Busch J, Stephan C, Klutzny A et al (2012) Impact of positive surgical margins on oncological outcome following laparoscopic radical prostatectomy (LRP): long-term results. World J Urol. [Epub ahead of print]
Porpiglia F, Fiori C, Manfredi M et al (2012) Surgical margin status of specimen and oncological outcomes after laparoscopic radical prostatectomy: experience after 400 procedures. World J Urol 30(2):245–250
Hruza M, Bermejo JL, Flinspach B, et al. (2013) Long-term oncological outcomes after laparoscopic radical prostatectomy. BJU Int 111(2):271–280
Kowalczyk KJ, Yu HY, Ulmer W, Williams SB, Hu JC (2012) Outcomes assessment in men undergoing open retropubic radical prostatectomy, laparoscopic radical prostatectomy, and robotic-assisted radical prostatectomy. World J Urol 30(1):85–89
Georgiou AN, Rassweiler J, Herrmann TR et al (2012) Evolution and simplified terminology of natural orifice transluminal endoscopic surgery (NOTES), laparoendoscopic single-site surgery (LESS), and mini-laparoscopy (ML). World J Urol 30(5):573–580
Nagele U, Anastasiadis AG, Walcher U et al (2012) Natural orifice (NOTES) transurethral sutureless radical prostatectomy with thulium laser support: first patient report. World J Urol 30(5):625–631
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All authors certify that there is no actual or potential conflict of interest in relation to this article and that there was no financial support for the present research.
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Verze, P., Scuzzarella, S., Martina, G.R. et al. Long-term oncological and functional results of extraperitoneal laparoscopic radical prostatectomy: one surgical team’s experience on 1,600 consecutive cases. World J Urol 31, 529–534 (2013). https://doi.org/10.1007/s00345-013-1052-0