A first experience with the endoscopic extraperitoneal radical prostatectomy after transurethral enucleation of the prostate

Kochkin A.D., Sevryukov F.A., Sorokin D.A., Karpuhin I.V., Puchkin A.B., Semenychev D.V.

Even when a fact is considered, that a standard method of the treatment of the localized prostate cancer for cT1a-T2b patients is traditional open radical prostatectomy, this operation is often performed using laparoscopic or extraperitoneal access. Depending on the surgeon experience, the relative contraindications for the endoscopic extraperitoneal radical prostatectomy (EERP) are obesity and previous transurethral resection of the prostate. Some surgeons nevertheless are prone to do this operation in these categories of the patients, while rating these situations as particularly complicated. During the analysis we were unable to find the references in the local and international medical databases regarding EERP in patients with previous transurethral enucleation of the prostate. It was a reason to share our first experience. When a retrospective comparison was done between EERP patients and patients who were operated using a standard approach, it was possible to denote some advantages of the endoscopic approach, while later showed better intraoperative visualization and the ability to dissect with precision, lower blood loss, taking into account that operation times were similar. Minimal invasiveness of the operation makes real the activization of the obese patients in the short-term perspective. Our first experience with the patients who had obesity and previously had an enucleation showed the perspectives, efficacy and safety for this method.

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