1 / 20

Radical Prostatectomy Sept 2009 till Aug 2010

Radical Prostatectomy Sept 2009 till Aug 2010. South Mersey Cancer Network Manal Kumar Consultant Urologist. Radical Prostatectomy. 80 patients 17 open (1/16) 42 to 73 yrs (63 yrs) 63 laparoscopic 44 to 74 yrs (63 yrs) Two patients did not undergo lap prostatectomy Extensive adhesions

penn
Télécharger la présentation

Radical Prostatectomy Sept 2009 till Aug 2010

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Radical Prostatectomy Sept 2009 till Aug 2010 South Mersey Cancer Network Manal Kumar Consultant Urologist

  2. Radical Prostatectomy • 80 patients • 17 open (1/16) • 42 to 73 yrs (63 yrs) • 63 laparoscopic • 44 to 74 yrs (63 yrs) • Two patients did not undergo lap prostatectomy • Extensive adhesions • Incidental bladder tumour

  3. Pre op PSA • Open • 4.2 to 18.8ng/ml(9.5ng/ml) • Lap RP • 0.8 to 29.7 ng/ml (8.5ng/ml)

  4. Patient Selection • All risk categories • Previous operations • TURPs, • inguinal and para-umbilical hernia • appendicectomy • BMI up to 38 • Prostate volume • 18 to 150 cc

  5. Pre op Staging

  6. Pre op Gleason Score

  7. Risk Category

  8. Lymphnode Dissection

  9. Nerve Sparing Prostatectomy

  10. OP Time • Open RRP • 120 to 220 min (182 min) • Lap RP • 150 to 270 min (201 min)

  11. OP Time

  12. Blood Loss • Open RRP • 500 ml to 3000 ml (1400ml) • Data was not recorded for 10 patients • One patient had blood transfusion • Lap RP • 50 to 1000 ml (265 ml) • No blood transfusion

  13. Laparoscopic Prostatectomy Complications • One (1.6%) incisional hernia (Clavien 3b) • One (1.6%) lymphocele (Clavien 3a) • One (1.6%) peno- bulbar stricture (Clavien 3a) • One blocked catheter (Clavien 1) • One patient had mild haematuria (Clavien 1) • No transfusion, no ileus and no conversion to open surgery • No anastamotic strictures

  14. Length of Stay • Open prostatectomy • 3 to 8 days (5.9 days) • Lap prostates • 2-6 days (2.3 days) • All except two patients were discharged within 3 days

  15. Positive Surgical Margins • Overall 26/71 (36%) • Open • 7/14 (50%) • 6 T3a • Laparoscopic prostatectomy • 19/57 (33%) • 8 T3a • 3 T3b • Only one bladder neck positive

  16. Post Operative PSA • PSA <0.1ng/ml 94% • Only 4 (6%) of LRP patients have PSA above 0.1% • Two of these patients had T3b disease and three of the four have Gleason 4+4 disease • 13/14 (92%) open prostatectomy patients had PSA <0.1 ng/ml

  17. Continence • 50 patients with > 3 mths follow up • Four (8%) wearing more than one pad a day • 2/12 open prostatectomy patients wearing more than one pad a day

  18. Acknowledgement Gill Riley

More Related