| Objectives:This study is designed to evaluate the clinical safety and therapeutic effect of laparoscopic radical prostatectomy (LRP) for high-risk prostate cancer (HRPC) by comparing the clinical outcomes of HRPC group patients with intermediate and low risk group patients.Methods:The clinical data of 101 patients with prostate cancer who underwent extra-peritoneal laparoscopic radical prostatectomy (eLRP) from January 2013 to July 2015 in Qilu Hospital of Shandong University were analyzed retrospectively. According to the D’Amico definition and postoperative pathological data, all patients with prostate cancer were divided into HRPC patients group and low-risk and intermediate-risk patients group. Preoperatively transrectal ultrasound-guided prostate biopsy was taken by all patients and their diagnoses were prostate cancer. These data were collected, including patients’age, body mass index (BMI), preoperative PSA, operative time, intraoperative blood loss, post-operation urine leakage, urinary continence rate, pathological data and so on.Results:46 patients were included in HRPC patients group with an average age of 68.3, the average BMI of 28.2 Kg/m2 and the average prostate volume of 46.5cm3, as well as 55 patients in the other group with the average age of 67.5, the average BMI of 27.5 Kg/m2 and the average prostate volume of 44.5 cm3, which were not of significant difference between two groups (P>0.05). The preoperative PSA level was 32.3±27.0 and 8.6±5.4 respectively and the Gleason score was 7.7±0.8 and 6.6±0.6 respectively, which were of statistical difference between two groups. The mean operation time (233.5±55.9min VS.228±53.6min, P>0.05), the mean intraoperative blood loss (180±28.3ml VS.150±25.6ml, P>0.05), the mean post-operation drainage (280.7 ± 48.3ml VS.262.9 ± 43.2ml, P>0.05), the mean catheterization time (20.5±3.2d VS.18.9±4.1d, P>0.05), the average post-operation hospitalization time (10.5±2.8d VS.9.7±3.5d, P>0.05), the urine leakage rate (8.70% Vs.7.27%, P> 0.05), lymphatic leakage rate (4.35% VS.3.64%, P>0.05) were not statistically different. There were no rectal injury, vascular injury, ureteral injury, blood transfusion and intraoperative death cases as well as not any postoperative incision infection, intestinal obstruction, lower extremity deep venous thrombosis, pulmonary embolism and other postoperative complications. According to the Clavien-Dindo classification, grade I postoperative complication (8.70% VS.7.27%, P>0.05) and gradeII complication (6.52% VS.5.45%, P>0.05) were not of statistical difference between two groups.3 months urinary continence rate was 86.96%,92.73% respectively (P>0.05) and 6 months urinary continence rate was 95.65%,96.36% respectively (P>0.05), which were not statistically different. The number of dissected lymph node were 6.24K±3.0, 5.95±3.2 respectively (P>0.05); However, HRPC patients group was of higher positive surgical margins (13.04% VS.0.00%, P<0.05) and lymph node positive rate (8.70% VS.0.00%, P<0.05), which was statistically different.Conclusions:Laparoscopic radical prostatectomy (LRP) is safe and feasible on technology for HRPC patients; What’s more, it can provide accurate information about tumor stage and grade. It is needed to perform further observations to explore its long-term therapeutic results as well. |
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