Laparoscopic Radical Prostatectomies Deemed Safe

Laparoscopic and open radical prostatectomies show similar pathologic results

MONDAY, Dec. 18 (HealthDay News) -- Laparoscopic radical prostatectomies are as safe and effective as open procedure for men with prostate cancer when similar case selection occurs, according to a head-to-head comparison of the two approaches reported in the December issue of Urology.

Douglas M. Dahl, M.D., of Massachusetts General Hospital in Boston, and colleagues compared pathological and surgical specimens of 286 laparoscopic radical prostatectomies and 714 open radical prostatectomies from 1,000 procedures performed from 2001 to 2005. They analyzed procedures for prostate weight, pathologic stage, Gleason score, surgical margin status and positive margin location.

There were no significant differences in the preoperative pathologic variables and Gleason score at biopsy between the two groups. Additionally, there was no difference in the final Gleason score or pathologic tumor stage between the two groups. The average prostate weight was 46.8 g in the laparoscopic arm and 46.0 g in the open arm. There were similar surgical margin status and no difference in positive margin location between the two surgical groups. Positive margins occurred mainly at the peripheral and apical regions in both groups.

"We provide direct comparison evidence that when patient selection is similar, laparoscopic radical prostatectomy and open radical prostatectomy have similar pathologic outcomes," the study authors conclude.

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