Comparison Of Surgical Technique(Open Vs Laparoscopic) On Long Term Function And Clinical Efficacy

Objective:Few studies to date have directly compared outcomes of open retropubic(RRP) and laparoscopic radical prostatectomy(LRP).We compared the clinical efficacy and long term function of two surgical technique with localized prostate cancer patients from January 2009 to December 2013 at Yi Jishan hospital of Wannan medical University.Material and method:From January 2009 to December 2013,we had 55 cases of TNM staging T1~T3a,Gleason score<7 patients with localized prostate cancer, 25 cases underwent laparoscopic radical prostatectomy,30 cases underwent open retropubic radical prostatectomy.The operation time, blood loss, time of catheter and drainage, the incidence of postoperative urinary leakage, the hospitalization duration were compared between the two groups.Date on postoperative urinary incontinence, erectile dysfunction and the blood PSA after three month were obtained via long-term follow-up on average 12 month.We used software SPSS 17.0 to examin all date,continuous variables were compared by T-test and categoral variables were compared by chi-square test and P<0.05 showed statistically significant.Results: From January 2009 to December 2013,we conducted 25 cases of laparoscopic radical prostatectomy and 30 cases of open retropubic radical prostatectomy,all caseswere successfully completed without the ureter, bladder and rectum injuries and patients without deep vein thrombosis, pulmonary embolism, myocardical infarction and other serious complications, surgical margins were negative.The average time of laparoscopic radical prostatectomy was 248.00±135.37 min, blood loss was 395.70±89.50 ml, time of catheter was 14.90±3.17 d, time of drainage was 4.80±3.88 d, time of hospitalization was 15.10±8.52 d, cases of postoperative urinary leakage was 5, cases of urinary incontinence was 2, cases of erectile dysfunction was 3, blood PSA was 1.01±1.57ng/ml after three month. The average time of open retropubic radical prostatectomy was 185.00±79.88 min, blood loss was 482.30±190.70 ml, time of catheter was 15.50±2.98 d, time of drainage was 5.60±2.67 d, time of hospitalization was 22.00±8.11 d, cases of postoperative urinary leakage was 12, cases of urinary incontinence was 3, cases of erectile dysfunction was 9, blood PSA was after three month.Conclusion: Open retropubic and laparoscopic radical prostatectomy represent effective surgical approaches for the treatment of clinically localized prostate cancer.There are no statistically significant between RRP and LRP on long term function.Although the time of laparoscopic radical prostatectomy is longer, LRP has a clearer vision to protect neurovascular bundle, it is better than RRP on intraoperative blood loss, injury of operation, and hospitalization duration.