| PURPOSE:To compare and evaluate the clinical outcomes between laparoscopic radical prostatectomy and open retropubic radical prostatectomy as the treatment of localized prostate cancer.MATERIALS AND METHODS:The clinical data of 100 cases of patients underwent laparoscopic radical prostatectomy and 59 cases of patients underwent open retropubic radical prostastectomy were analyzed retrospectively at our Institute between June 2003 and July 2007. Indexes of preoperative parameters, operating time, bleeding volume during operation, blood transfusions rate, recovery time of intestinal function, the duration of catheterization,hospitalization stay after operation, Peroperative complications, continence rate, potency rate and 2-year biochemical recurrence of the two procedures were compared.RESULTS:Two groups were all successfully performed. No patient was converted to open surgery in the LRP group. The mean operating time of pre-50 cases and post-50 cases in the LRP group were (304.30±82.33) minutes and (177.60±48.83) minutes, respectively. There was statistical difference between the Previous group and the RRT group which mean operating time was (171.04±41.31) minutes (P<0.01), there was no statistical difference between the posterior and the RRP group P>0.05). The mean bleeding volume during operation, blood transfusions rate, recovery time of intestinal function, the duration of catheterization,hospitalization stay after operation between LRP group and RRP group were (356.67±288.81) ml and (1021.43±660.65)ml (P< 0.01); 18.00%(18/100) and 54.24%(32/59) (P< 0.01); (1.81±0.78) days and 2.69±1.51) days (P< 0.01); (8.65±3.42) days and (15.21±4.95) days (P< 0.01); (15.17±5.96) days and (17.86±6.98) days (P< 0.05), respectively. In the LRP group, three cases of severe bleeding occurred, three cases of vesical triangle injury, one case of rectal injury, two cases of obturator nerve injury, five cases of peritoneum injury, nine cases of Urinary leakage, the postoperative positive margin rate was 15.00%. In the RRP group, six cases of severe bleeding occurred, three cases of Urinary leakage, one case of incision infection, two cases of deep vein thrombosis, the postoperative positive margin rate was 20.34%. All 100 patients underwent LRP were followed up (22.27±18.10) months on average, the one-year biochemical recurrence rate was 7.04%(5/71), the two-year biochemical recurrence rate was 24.4%(11/45), the mean prostate-specific antigen doubling time of the patients with biochemical recurrence was (3.49±3.09) months, the six-month continence rate was 57.14%(52/91), the twelve-month continence rate was 89.74% (70/78),50%(3/6) had satisfactory penile erection after nerve-sparing radical prostatectomy, three cases were dead. All 59 patients underwent RRP were followed up (24.31±15.93) months on average, the one-year biochemical recurrence rate was 8.11%(3/37), the two-year biochemical recurrence rate was 31.03%(9/29), the mean prostate-specific antigen doubling time of the patients with biochemical recurrence was (5.73±4.05) months, the six-month continence rate was 64.81%(35/54), the twelve-month continence rate was 91.84%(45/49),44.44%(4/9) had satisfactory penile erection after nerve-sparing radical prostatectomy, one case was dead.CONCLUSIONS:laparoscopic radical prostatectomy not only perform better cosmetic results, less blood loss and faster recovery,but also offer equivalent oncological and functional results compared with open retropubic radical prostatectomy. LRP have the potential to be the gold standard in the treatment of localized prostate cancer.
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