Introduction of Minimum Incision Endoscopic Radical Prostatectomy with Intentional Wide Resection for Locally Advanced Prostate Cancer at the St. Marianna University School of Medicine

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  • Nakazawa Ryuto
    Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan
  • Nishi Tomohiro
    Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan
  • Yoza Naoto
    Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan
  • Matsumura Kaori
    Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan
  • Sato Yoshitsugu
    Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan
  • Usuba Wataru
    Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan
  • Aoki Naoto
    Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan
  • Fujimoto Eisuke
    Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan
  • Hachisuka Satoshi
    Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan
  • Katsuoka Yuichi
    Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan
  • Aida Koichirou
    Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan
  • Sasaki Hideo
    Department of Urology, St. Marianna University School of Medicine, Kawasaki, Japan

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Other Title
  • 聖マリアンナ医科大学における局所進行性前立腺癌に対する鏡視下小切開拡大前立腺全摘除術の導入

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<p>Purpose: To improve the surgical curability of prostate cancer, we introduced minimum incision endoscopic radical prostatectomy with intentional wide resection (MRP–WR) at our hospital. We report the surgical outcomes of MRP–WR in comparison with those of MRP, which was used previously.<br/>Subjects and methods: The analysis included 21 patients with prostate cancer who underwent MRP–WR between January 2016 and March 2017 and a control group of 23 patients who underwent MRP between April 2013 and May 2015. The surgical outcomes were retrospectively analyzed by examining clinical parameters, including surgical time, hemorrhage volume, number of lymph nodes removed, duration of indwelling urinary catheterization, duration of hospitalization, positive- surgical margin rate, and initial postoperative serum prostate-specific antigen (PSA) level.<br/>Results: Compared with the patients in the MRP group, those in the MRP–WR group had a longer mean surgery time (251 vs. 318 min, P<0.0001), lower mean hemorrhage volume (1199 vs. 292 mL, P<0.0001), larger mean number of removed lymph nodes (3.7 vs. 19.1, P<0.0001), longer duration of indwelling urinary catheterization (6.2 vs. 9.9 days, P=0.0042), and a lower positive- surgical- margin rate (48 vs. 19%, P=0.0443). The initial postoperative PSA level was below the detection limit in 67% of the patients in the MRP–WR group, whereas it was below the detection limit in only 4% in the MRP group, indicating that patients in the MRP–WR group had a significantly lower initial postoperative PSA level (P<0.0001).<br/>Conclusion: The newly introduced MRP–WR procedure appears to be superior to conventional MRP in terms of the complete resection rate of prostate cancer, improvement in treatment outcomes, and reduction in hemorrhage.</p>

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