3D Laparoscopic radical prostatectomy in older patients: our experience
M. Falsaperla, G. Calabrese, G. Bonvissuto
Vol.5 (2020), issue 2, pag. 5 - 12
| Received | 10/08/2020 |
| Accepted | 27/08/2020 |
| Published | 25/09/2020 |
| Review by | Single-blind |
| DOI | https://doi.org/10.48253/AGO1 |
ABSTRACT
Prostate cancer is the most common malignant tumor in men, ac- counting for about 20% of all diagnosed cancers. Recent impro- vements in medical care have increased life expectancy of these patients. The most appropriate treatment for prostate cancer in el- derly patients is complex and should be based on the clear defini- tion of the aim, the evaluation of both benefits and risks related to the therapy and its potential effects on functional loss and quality of life. However, in recent years, new developments in the fields of anesthesiology, perioperative care, and surgical techniques have modified the picture and several studies confirm the feasibility of an optimal cytoreduction surgery with a complication rate similar to younger patients. Laparoscopic radical prostatectomy (RP) se- ems to be feasible for elderly well-selected patients. We report our experience with patients older than 75 years old who underwent laparoscopic radical prostatectomy (LRP). Laparoscopic surgery has been accepted as a minimally invasive treatment to reduce the morbidity and a number of studies have demonstrated the feasibility of laparoscopy with significant advantages also in the elderly. In this article, we wanted to underline our experience and its good results in the laparoscopic treatment of clinically localized and intermediate prostate cancer in older patients. Since June 2016 to June 2019, 42 patients aged 75 years or older (range: 75–79 years) at time of surgery were included in the study and underwent laparoscopic radical prostatectomy. Clinical features have been a preoperative PSA < 12 ng/ml; pathologic stage ≤ cT3aN0M0; Gleason Score < 7. Four (9,5 %) perioperative complications occurred but no conver- sion was necessary. Ten patients (23,8 %) had a pT3 disease and the overall positive surgical margins rate was 15%. With a median follow-up of 12 months, no patient has died and six had biochemical recurrence; 87% of patients were continent (no pad) and potency (erection sufficient for intercourse) rate was 35%.