�UroToday.com - In the age of minimally invasive surgery, laparoscopic and robotic assisted laparoscopic prostatectomy has been associated with a substantial increment in operative costs without a significant improvement in outcomes to date. As a outcome, there has been renewed interest in one of the original approaches to prostate cancer. In this presentation we compare the MUSC experience with perineal prostatectomy (RPP) to promulgated results using laparoscopic and robot-assisted laparoscopic prostatectomy (LRP, RALP).
Our experience with over 300 consecutive perineal prostatectomies is presented and operative technique reviewed in detail. Issues such as hospital stay, intra-operative blood loss, length of catheterisation, complications, both long and short term, and outcomes will be reviewed. Selective indications for a perineal prostatectomy will be outlined and discussed.
The mean operative time for RPP was less than that for LRP or RALP. Estimated blood loss was equivalent for RPP and RALP and less than that for LRP. Length of catheterisation in the RPP grouping was longer but was based on a tutelage map and has been modified to 7 days without problems in the last 75 pts. Length of hospital stay was equivalent for all techniques and hospital costs were significantly less for RPP vs. the alternatives.
A detailed discourse of the current evidence and its quality concerning the assorted approaches volition be undertaken and the audience should have a clear agreement of the current issues at the end of the intro.
Presented by: Thomas Keane, MD, at the Masters in Urology Meeting - July 31, 2008 - August 2, 2008 - Elbow Beach Resort, Bermuda
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