ОПТИМИЗАЦИЯ ТЕХНИКИ ЛАПАРОСКОПИЧЕСКОЙ НЕРВОСБЕРЕГАЮЩЕЙ РАДИКАЛЬНОЙ ПРОСТАТЭКТОМИИ

Аннотация

Objective: to determine the optimal technique of laparoscopic nerve-sparing radical prostatectomy (RPE). Materials and methods. The PubMed database was used to examine matters on the anatomy of the prostate, its surrounding structures, and different techniques of laporoscopic RPE (LRPE). This has led to the conclusion that the Brussels technique provides better results in nervesparing at LRPE. In July 2008 to July 2009, 17 laparoscopic radical prostatectomies (15 patients underwent extrafascial prostatectomy, 2 patients had interfascial prostatectomy) were performed using the Brussels technique via transperitoneal approach; the results were prospectively evaluated. Results. The mean follow-up was 5.3 months so we cannot adequately assess the results now. The health status of the patients was evaluated using the questionnaires (International Continence Society and International Index of Erectile Function-5) filled in by them before and after surgery. Four of 5 patients who had been followed up for more than 6 months were continent, 1 patient used 1 pad. Out of 2 patients with a median follow-up of 2 months who had led a sexual life before surgery (International Index of Erectile Function-5 greater than 20 scores), erection was preserved in one patient after bilateral nerve-sparing prostatectomy and not preserved in the other after unilateral one. Conclusion. Anterior approach to the prostate provides better control of the neurovascular bundles in the seminal vesicular region. The modified Brussels technique is more preferable in performing LRPE.