Laparoscopic radical prostatectomy: contemporary comparison with open surgery.

Overview

INTRODUCTION: The optimal outcome of radical prostatectomy is to cure cancer with the least impact on quality of life. The aim of this paper is to review the existent literature and attempt to compare the results of the retropubic (RRP) with the laparoscopic (LRP) approach. METHODOLOGY: Extensive Medline literature search for terms "radical retropubic prostatectomy" and "laparoscopic radical prostatectomy" from 1980 to 2006 to compare cancer control, functional outcomes and morbidity for both groups. Only full length English language articles including 100 or more patients were considered. RESULTS: The 5-year biochemical recurrence rates range from 70-92% for the RRP vs. 82-91% for the LRP. The global positive surgical margin rates are 12-20% for the RRP and 17-30% for the LRP. The continence rate for the RRP varies from 70-93%; the LRP varies from 82-95% for 12 months. Considering potency 12 months after surgery, the rates are 17-75% for the RRP vs. 52-78% for the LRP. The blood loss for the RRP ranges from 818 to 1,500 ml and 220 to 1,100 for the LRP. CONCLUSIONS: The concurrent literature lacks randomized trials comparing the different surgical techniques. No definitive conclusions can be drawn.