The surgical technique of extraperitoneal laparoscopic radical prostatectomy with neurovascular bundle preservation and its effect on micturition control and sexual function in patients with prostate cancer / 中华老年医学杂志

ABSTRACT

Objective To analyze the surgical technique of extraperitoneal laparoseopic radical prostatectomy with neurovascular bundle preservation and its effect on micturition control and sexual function in patients with prostate cancer. Methods Twenty-two patients with a median age of 66. 9 years underwent extraperitoneal laparoscopic radical prostatectomy with neurovascular bundle preservation from October 2005 to March 2009 in our hospital and Shanghai Changzheng hospital. All patients had no erectile dysfunction. According to the pathology, there were 2 cases of PIN high grade, 4 cases of Tla-b, 9 cases of Tlc, 4 cases of T2a-b, 2 cases of T2e and 1 case of T3a. Results All operation were successful and no case was conversed to open surgery. The average operation time was 225 min and the mean blood loss was 850ml. The amount of blood loss in 1 case was 1200 ml because of injuring deep dorsal vein of penis. 4 cases received blood transfusion, gatheters of all patients were removed 2 weeks after operation, and three cases with mild incontinence regained continence of urine after 6 months follow-up. No patient occurred postoperative vesicourethral anastomotic leakage of urine. The surgical margin of 1 case was positive. No biochemical index of prostatl cancer recurred during postoperative follow-up of 10-24 months (with an average of 16 months). 20 cases had sexual function recovery after operation. Conclusions The extraperitoneal laparoscopie radical prostatectomy with neurovascular bundle preservation for prostate cancer is a safe and effective treatment method with less bleeding, small damage and less complications. It can guarantee the maximum of micturition control and sexual function, which is worthy to be popularized in the clinic.