Top

Published in:

01-12-2008 | Topic Paper

Prevention and management of perioperative complications in laparoscopic and endoscopic radical prostatectomy

Authors: Evangelos Liatsikos, Robert Rabenalt, Martin Burchardt, Miguel-Ramirez Backhaus, Minh Do, Anja Dietel, Johanna Wasserscheid, Costantinos Constantinides, Panagiotis Kallidonis, Michael C. Truss, Thomas R. Herrmann, Roman Ganzer, Jens-Uwe Stolzenburg

Published in: World Journal of Urology | Issue 6/2008

Abstract

Introduction

Laparoscopic transperitoneal radical prostatectomy (LRP) and endoscopic extraperitoneal radical prostatectomy (EERPE) are established techniques for the management of localized prostate cancer in numerous specialized urologic centers worldwide.

Results

The complication rates of LRP and EERPE are ranging between 2 and 17%. Rare but possible complications are vascular injuries, bowel injury, lymphocele formation, port-site hernia, anastomotic leakage, gas embolism and catheter obstruction and other rare events.

Conclusion

Prevention and management of complications requires high surgical expertise and adequate standardization of the technique.

Materials and methods

We herein review our experience with the endoscopic extraperitoneal radical prostatectomy in a series of 1,800 consecutive patients regarding the appearance of complications and their management.

Bollens R, Vanden Bossche M, Roumeguere T, Damoun A, Ekane S, Hoffmann P, Zlotta AR, Schulman CC (2001) Extraperitoneal laparoscopic radical prostatectomy. Results after 50 cases. Eur Urol 40:65–69PubMedCrossRef

Stolzenburg J-U, Rabenalt R, Do M, Ho K, Dorschner W, Waldkirch E, Jonas U, Schütz A, Horn L, Truss MC (2005) Endoscopic extraperitoneal radical prostatectomy (EERPE)—oncological and functional results after 700 procedures. J Urol 174:1271–1275PubMedCrossRef

Rozet F, Galiano M, Cathelineau X, Barret E, Cathala N, Vallancien G (2005) Extraperitoneal laparoscopic radical prostatectomy: a prospective evaluation of 600 cases. J Urol 174:908–911PubMedCrossRef

Rassweiler J, Hruza M, Teber D, Su LM (2006) Laparoscopic and robotic assisted radical prostatectomy—a critical analysis of the results. Eur Urol 49:612–624PubMedCrossRef

Lepor H, Kaci L (2003) Contemporary evaluation of operative parameters and complications related to open radical retropubic prostatectomy. Urology 62:702–706PubMedCrossRef

Gillitzer R, Melchior SW, Hampel C, Wiesner C, Fichtner J, Thüroff JW (2004) Specific complications of radical perineal prostatectomy: a single institution study of more than 600 cases. J Urol 172:124–128PubMedCrossRef

Weldon VE, Tavel FR, Neuwirth H (1997) Continence, potency and morbidity after radical perineal prostatectomy. J Urol 158:1470–1475PubMedCrossRef

Lance RS, Freidrichs PA, Kane C, Powell CR, Pulos E, Moul JW, McLeod DG, Cornum RL, Brantley Thrasher J (2001) A comparison of radical retropubic with perineal prostatectomy for localized prostate cancer within the Uniformed Services Urology Research Group. BJU Int 87:61–65PubMedCrossRef

Lepor H, Nieder AM, Ferrandino MN (2001) Intraoperative and postoperative complications of radical retropubic prostatectomy in a consecutive series of 1,000 cases. J Urol 166:1729–1733PubMedCrossRef

10.

Catalona WJ, Carvalhal GF, Mager DE, Smith DS (1999) Potency, continence and complication rates in 1,870 consecutive radical retropubic prostatectomies. J Urol 162:433–438PubMedCrossRef

11.

Dillioglugil Ö, Leibman BD, Leibman NS, Kattan MW, Rosas AL, Scardino PT (1997) Risk factors for complications and morbidity after radical retropubic prostatectomy. J Urol 157:1760–1767PubMedCrossRef

12.

Stolzenburg JU, Do M, Rabenalt R, Pfeiffer H, Horn L, Truss MC, Jonas U, Dorschner W (2003) Endoscopic extraperitoneal radical prostatectomy (EERPE)—initial experience after 70 procedures. J Urol 169:2066–2071PubMedCrossRef

13.

Stolzenburg JU, Truss MC (2003) Technique of laparoscopic (endoscopic) radical prostatectomy. BJU Int 91:749–757PubMedCrossRef

14.

Stolzenburg JU, Do M, Pfeiffer H, König F, Aedtner B, Dorschner W (2002) The endoscopic extraperitoneal radical prostatectomy (EERPE): technique and initial experience. World J Urol 20:48–55PubMedCrossRef

15.

Stolzenburg JU, Truss MC, Do M, Rabenalt R, Pfeiffer H, Dunzinger M, Aedtner B, Stief CG, Jonas U, Dorschner W (2003) Evolution of endoscopic extraperitoneal radical prostatectomy (EERPE)—technical improvements and development of a nerve-sparing, potency-preserving approach. World J Urol 21:147–152PubMedCrossRef

16.

Stolzenburg JU, Truss MC, Bekos A, Do M, Rabenalt R, Stief CG, Hoznek A, Abbou CC, Neuhaus J, Dorschner W (2004) Does the extraperitoneal laparoscopic approach improve the outcome of radical prostatectomy? Curr Urol Rep 5:115–122PubMedCrossRef

17.

Stolzenburg JU, Rabenalt R, Do M, Truss MC, Burchardt M, Hermann TR et al (2007) Endoscopic extraperitoneal radical prostatectomy: the University of Leipzig experience of 1,300 cases. World J Urol 25:45–51PubMedCrossRef

18.

Dindo D, Demarines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213PubMedCrossRef

19.

Remzi M, Klingler HC, Tinzl MV, Fong YK, Lodde M, Kiss B, Marberger M (2005) Morbidity of laparoscopic extraperitoneal versus transperitoneal radical prostatectomy versus open retropubic radical prostatectomy. Eur Urol 48:83–89PubMedCrossRef

20.

Martina GR, Giumelli P, Scuzzarella S, Remotti M, Caruso G, Lovisolo J (2005) Laparoscopic extraperitoneal radical prostatectomy–learning curve of a laparoscopy-naive urologist in a community hospital. Urology 65:959–963PubMedCrossRef

21.

Hoznek A, Antiphon P, Borkowski T, Gettman M, Katz R, Salomon L, Zaki S, de la Taille A, Abbou CC (2003) Assessment of surgical technique and perioperative morbidity associated with extraperitoneal versus transperitoneal laparoscopic radical prostatectomy. Urology 61:617–622PubMedCrossRef

22.

Van Velthoven RF (2005) Laparoscopic radical prostatectomy: transperitoneal versus retroperitoneal approach: is there an advantage for the patient? Curr Opin Urol 15:83–88PubMedCrossRef

23.

Erdogru T, Teber D, Frede T, Marrero R, Hammady A, Seemann O, Rassweiler J (2004) Comparison of transperitoneal radical prostatectomy using Match- Pair analysis. Eur Urol 46:312–320PubMedCrossRef

24.

Poulakis V, Witzsch U, Vries R, Dillenburg W, Becht E (2007) Laparoscopic radical prostatectomy in men older than 70 years of age with localized prostate cancer: comparison of morbidity, recovalescence and short- term clinical outcomes between younger and older men. Eur Urol 51:1341–1349PubMedCrossRef

25.

Galli S, Simonato A, Bozzola A, Gregori A, Lissiani A, Scaburri A, Gaboardi F (2006) Oncologic outcome and continence recovery after laparoscopic radical prostatectomy: 3 years’ follow-up in a “second generation center”. Eur Urol 49:859–865PubMedCrossRef

26.

Rassweiler J, Sentker L, Seemann O, Hatzinger M, Stock C, Frede T (2001) Heilbronn laparoscopic radical prostatectomy technique and results after 100 cases. Eur Urol 40:54–64PubMedCrossRef

27.

Guillonneau B, Gupta R, El Fettouh H, Cathelineau X, Baumert H, Vallancien G (2003) Laparoscopic management of rectal injury during radical prostatectomy. J Urol 169:1694–1696PubMedCrossRef

28.

Bishoff JT, Allaf ME, Kirkels W, Moore RG, Kavoussi LR, Schroder F (1999) Laparoscopic bowel injury: incidence and clinical presentation. J Urol 161:887–890PubMedCrossRef

29.

Lein M, Stibane I, Mansour R, Hege C, Roigas J, Wille A, Jung K et al (2006) Complications, urinary continence and oncologic outcome of 1000 laparoscopic transperitoneal radical prostatectomies- experience at the Charite Hospital Berlin, Campus Mitte. Eur Urol 50:1278–1284PubMedCrossRef

30.

Arai Y, Egawa S, Terachi T, Suzuki K et al (2003) Morbidity of laparoscopic radical prostatectomy: summary of early multi-institutional experience in Japan. Int J Urol 10:430–434PubMedCrossRef

31.

Groenman FA, Peters LW, Rademaker BMP et al (2008) Embolism of air and gas in hysteroscopic procedures: pathophysiology and implication for daily practice. J Minim Invasive Gynecol 15:241–247PubMedCrossRef

32.

Guillonneau B, Rozet F, Cathelineau X, Lay F, Barret E, Doublet JD, Baumert H, Vallancien G (2002) Perioperative complications of laparoscopic radical prostatectomy: the Montsouris 3-year experience. J Urol 167:51–56PubMedCrossRef

33.

Hu JC, Nelson RA, Wilson TG, Kawachi MH et al (2006) Perioperative complications of laparoscopic and robotic assisted laproscopic radical prostatectomy. J Urol 175:541–546PubMedCrossRef

34.

Stolzenburg JU, Rabenalt R, Do M, Lee B, Truss MC et al (2006) Categorisation of complications of endoscopic extraperitoneal and laparoscopic transperitoneal radical prostatectomy. World J Urol 24:88–93PubMedCrossRef

35.

Briganti A, Chun FK, Salonia A, Suardi N, Gallina A et al (2006) Complications and other surgical outcomes associated with extended pelvic lymphadenectomy in men with localized prostate cancer. Eur Urol 50:1006–1013PubMedCrossRef

36.

Cathelineau X, Cahill D, Widmer H, Rozet F, Baumert H, Vallancien G (2004) Transperitoneal or extraperitoneal approach for laparoscopic radical prostatectomy: a false debate over a real challenge. J Urol 171:714–716PubMedCrossRef

37.

Ruiz L, Salomon L, hoznek A, Vordos D, Yiou R et al (2004) Comparison of early oncologic results of laparoscopic radical prostatectomy by extraperitoneal versus transperitoneal approach. Eur Urol 46:50–54PubMedCrossRef

38.

Ahlering TE, Eichel L, Chou D, Skarecky D (2005) Feasibility study for robotic radical prostatectomy cautery-free neurovascular bundle preservation. Urology 65:994–997PubMedCrossRef

39.

Blana A, Straub M, Wild PJ, Lunz JC, Bach T, Wieland WF, Ganzer R (2007) Approach to endoscopic extraperitoneal radical prostatectomy (EERPE): the impact of previous laparoscopic experience on the learning curve. BMC Urol 7:11PubMedCrossRef

40.

Stolzenburg JU, Rabenalt R, Do M, Horn LC, Liatsikos EN (2006) Modular training for residents with no prior experience with open pelvic surgery in endoscopic extraperitoneal radical prostatectomy. Eur Urol 49:491–500PubMedCrossRef

41.

Sugiono M, Teber D, Anghel G, Gözen AS, Stock C et al (2007) Assessing the predictive validity and efficacy of a multimodal training programme for laparoscopic radical prostatectomy (LRP). Eur Urol 51:1332–1340PubMedCrossRef

42.

Stolzenburg JU, Schwaibold H, Bhanot SM, Rabenalt R, Do M, Truss M, Ho K, Anderson C (2005) Modular surgical training for Endoscopic Extraperitoneal Radical Prostatectomy (EERPE). BJU Int 96:1022–1027PubMedCrossRef

43.

Stolzenburg JU, Gettmann MT, Liatsikos EN (2007) Endoscopic extraperitoneal radical prostatectomy. Springer, Berlin. ISBN-978-3-540-45533-2

Title: Prevention and management of perioperative complications in laparoscopic and endoscopic radical prostatectomy
Authors: Evangelos Liatsikos
Robert Rabenalt
Martin Burchardt
Miguel-Ramirez Backhaus
Minh Do
Anja Dietel
Johanna Wasserscheid
Costantinos Constantinides
Panagiotis Kallidonis
Michael C. Truss
Thomas R. Herrmann
Roman Ganzer
Jens-Uwe Stolzenburg
Publication date: 01-12-2008
Publisher: Springer-Verlag
Published in: World Journal of Urology / Issue 6/2008
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-008-0328-2

At a glance: The STEP trials

Springer Medicine

Prevention and management of perioperative complications in laparoscopic and endoscopic radical prostatectomy

Abstract

Introduction

Results

Conclusion

Materials and methods

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Results

Conclusion

Materials and methods

Please log in to get access to this content

Other articles of this Issue 6/2008

Analysis of three different vesicourethral anastomotic techniques in laparoscopic radical prostatectomy

Reduction in incidence of lymphocele following extraperitoneal radical prostatectomy and pelvic lymph node dissection by bilateral peritoneal fenestration

Intraoperative complications of laparoscopic adrenalectomy

Analysis of complications from 600 retroperitoneoscopic procedures of the upper urinary tract during the last 10 years

Retroperitoneal laparoscopic radical nephrectomy: Intermediate oncological results

Complications of laparoscopic partial nephrectomy