Acta Medica Okayama. Initial Report of Hybrid Radical Prostatectomy for Prostate Cancer:Reduced Bleeding, Clear Vision, and Secure Surgical Margins

Transcription

1 Acta Medica Okayama Volume 62, Issue Article 4 DECEMBER 2008 Initial Report of Hybrid Radical Prostatectomy for Prostate Cancer:Reduced Bleeding, Clear Vision, and Secure Surgical Margins Takashi Saika Yasuyuki Kobayashi Toyohiko Watanabe Daisuke Manabe Shin Ebara Shinya Uehara Yasutomo Nasu Hiromi Kumon Department of Urology, Okayama University Graduate School of Medicine, Dentistry and saika@cc.okayama-u.ac.jp Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Department of Urology, Okayama University Graduate School of Medicine, Dentistry and kumon@md.okayama-u.ac.jp Copyright c 1999 OKAYAMA UNIVERSITY MEDICAL SCHOOL. All rights reserved.

2 Initial Report of Hybrid Radical Prostatectomy for Prostate Cancer:Reduced Bleeding, Clear Vision, and Secure Surgical Margins Takashi Saika, Yasuyuki Kobayashi, Toyohiko Watanabe, Daisuke Manabe, Shin Ebara, Shinya Uehara, Yasutomo Nasu, and Hiromi Kumon Abstract To evaluate morbidity in Hybrid Radical Prostatectomy (HRP, hybridized laparoscopic and open retropubic radical prostatectomy). The operative and pathological outcomes obtained in 25 consecutive patients who underwent HRP were reviewed. The median operating time was 220min, median blood loss was 550ml, and no patient required an allogenic blood transfusion. No severe postoperative complications were observed. The surgical margin was positive in 12% of all patients, and in 1 patient with pt2 or less (4.5%). These results indicate that HRP is safe and may be able to combine the benefits of both laparoscopic and open procedures. KEYWORDS: prostate cancer, radical prostatectomy, hybrid surgery, morbidity, positive surgical margin Copyright c 2008 OKAYAMA UNIVERSITY MEDICAL SCHOOL. All rights reserved

3 Saika et al.: Initial Report of Hybrid Radical Prostatectomy for Prostate Cance Initial Report of Hybrid Radical Prostatectomy for Prostate Cancer: Reduced Bleeding, Clear Vision, and Secure Surgical Margins * Produced by The Berkeley Electronic Press,

4 Acta Medica Okayama, Vol. 62 [2008], Iss. 6, Art

5 Saika et al.: Initial Report of Hybrid Radical Prostatectomy for Prostate Cance ʼ Produced by The Berkeley Electronic Press,

6 Acta Medica Okayama, Vol. 62 [2008], Iss. 6, Art. 4 Saika et al. Acta Med. Okayama Vol. 62, No. 6 through a single minimal incision without pneumoperitoneum and trocars [16, 17]. However, although they have reported that the magnification provided by the endoscope allows easy identification of the tissue A Fig. 2 planes and more precise dissection, they diminished this advantage with their limitations of gas less and port less. In minilaparotomy, a surgical field that is narrower than one under the pneumoretroperitoneum B A, 45-mm Endo-GIA stapler allows for one-step stapling and division of the deep dorsal vein complex; B, The anterior urethra wall (arrows) is exposed after firing of the Endo-GIA stapler. 1,200 blood loss surgical time Blood loss (g) 1, Surgical time (min) Pts. No. Fig. 3 Longitudinal results of Hybrid Radical Prostatectomy with regard to blood loss and operative time in relation to body mass index (BMI). BMI less than 25 kg/m2 BMI 25 kg/m2 or more but 30 kg/m2 or less BMI greater than 30 kg/m2 4

7 Saika et al.: Initial Report of Hybrid Radical Prostatectomy for Prostate Cance Produced by The Berkeley Electronic Press,

8 Acta Medica Okayama, Vol. 62 [2008], Iss. 6, Art