Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press1710.17650/1726-9776-2010-6-1-39-44PROSTATE CANCERРАК ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫOPTIMIZATION OF LAPAROSCOPIC NERVE-SPARING RADICAL PROSTATECTOMYОПТИМИЗАЦИЯ ТЕХНИКИ ЛАПАРОСКОПИЧЕСКОЙ НЕРВОСБЕРЕГАЮЩЕЙ РАДИКАЛЬНОЙ ПРОСТАТЭКТОМИИPerepechayV. A.ПерепечайВ. А.
Russian Federation
MedvedevV. L.МедведевВ. Л.
Russian Federation
DimitriadiS. N.ДимитриадиС. Н.
Russian Federation
District Medical Center, Federal Biomedical Agency of Russia, Rostov-on-DonФГУ Южный окружной медицинский центр ФМБА России, Ростов-на-ДонуKuban State Medical University, KrasnodarКубанский государственный медицинский университет, Краснодар300320106139442407201424072014https://oncourology.abvpress.ru/oncur/article/view/17

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.

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.

laparoscopic radical prostatectomynerve-sparing procedureBrussels techniquespreserved potency1. Schuessler W.W., Kavoussi L.R., Clayman R.V. Laparoscopic radical prostatectomy: initial case report [abstr 130]. J Urol Suppl 1992;147:246.Schuessler W.W., Kavoussi L.R., Clayman R.V. Laparoscopic radical prostatectomy: initial case report [abstr 130]. J Urol Suppl 1992;147:246.2. Schuessler W.W., Schulam P., Clayman R.V., Kavoussi L.R. Laparoscopic radical prostatectomy: initial short term experience. Urology 1997;50:854.Schuessler W.W., Schulam P., Clayman R.V., Kavoussi L.R. Laparoscopic radical prostatectomy: initial short term experience. Urology 1997;50:854.3. Guillonnea B., Cathelineau X., Baret E. et al. Laparoscopic radical prostatectomy: technical and early oncological assessment of 40 operations. Eur Urol 1999;36:14.Guillonnea B., Cathelineau X., Baret E. et al. Laparoscopic radical prostatectomy: technical and early oncological assessment of 40 operations. Eur Urol 1999;36:14.4. Guillonnea B., Vallancien G. Laparoscopic radical prostatectomy: the Montsouris experience. J Urol 2000;163:418.Guillonnea B., Vallancien G. Laparoscopic radical prostatectomy: the Montsouris experience. J Urol 2000;163:418.5. Kavoussi L.R., Schuessler W.W., Vancaille T.G., Clayman R.V. Laparoscopic approach to the seminal vesicle. J Urol 1993;150:417.Kavoussi L.R., Schuessler W.W., Vancaille T.G., Clayman R.V. Laparoscopic approach to the seminal vesicle. J Urol 1993;150:417.6. Rabboy A., Ferzli G., Albert P. Initial experience with extraperitoneal endoscopic radical retropubic prostatectomy. Urology 1997;50:849.Rabboy A., Ferzli G., Albert P. Initial experience with extraperitoneal endoscopic radical retropubic prostatectomy. Urology 1997;50:849.7. Textbook of laparoscopic urology. Inderbir S. Gill ed. Informa Healthcare USA, Inc, 2006.Textbook of laparoscopic urology. Inderbir S. Gill ed. Informa Healthcare USA, Inc, 2006.8. Abbou C.C., Salomon L., Hoznek A. et al. Laparoscopic radical prostatectomy: preliminary results. Urology 2000; 55:630.Abbou C.C., Salomon L., Hoznek A. et al. Laparoscopic radical prostatectomy: preliminary results. Urology 2000; 55:630.9. Rassweiler J., Senker L., Seeman O. et al. Heilbronn laparoscopic radical prostatectomy: technique and result after 100 cases. Eur Urol 2001;40:54.Rassweiler J., Senker L., Seeman O. et al. Heilbronn laparoscopic radical prostatectomy: technique and result after 100 cases. Eur Urol 2001;40:54.10. Bolens R., Vanden Bossche M., Rhoumeguere T.H. et al. Extraperitoneal laparoscopic radical prostatectomy: result after 50 cases. Eur Urol 2001;40:65.Bolens R., Vanden Bossche M., Rhoumeguere T.H. et al. Extraperitoneal laparoscopic radical prostatectomy: result after 50 cases. Eur Urol 2001;40:65.11. Walsh P.C., Donker P.J. Impotence following radical prostatectomy: insight into etiology and prevention. J Urol 1982;128:492-7.Walsh P.C., Donker P.J. Impotence following radical prostatectomy: insight into etiology and prevention. J Urol 1982;128:492-7.12. Menon M., Tewari A., Peabody J. et al. Vattikuti Institute prostatectomy: technique. J Urol 2003;169:2289-92.Menon M., Tewari A., Peabody J. et al. Vattikuti Institute prostatectomy: technique. J Urol 2003;169:2289-92.13. Kiyoshima K., Yokomizo A., Yoshida T. et al. Anatomical features of periprostatic tissue and its surroundings: a histological analysis of 79 radical retropubic prostatectomy specimens. Jpn J Clin Oncol 2004;34:463-8.Kiyoshima K., Yokomizo A., Yoshida T. et al. Anatomical features of periprostatic tissue and its surroundings: a histological analysis of 79 radical retropubic prostatectomy specimens. Jpn J Clin Oncol 2004;34:463-8.14. Van Ophonen A., Roth S. The anatomy and embryological origins of the fascia of Denonvilliers: A medico-historical debate. J Urol 1997;157:3-9.Van Ophonen A., Roth S. The anatomy and embryological origins of the fascia of Denonvilliers: A medico-historical debate. J Urol 1997;157:3-9.15. Brooks J.D., Scott E.E., Wen-Min Chao. Anatomy of rectouretralis muscle. Eur Urol 2002;41(1):94-100.Brooks J.D., Scott E.E., Wen-Min Chao. Anatomy of rectouretralis muscle. Eur Urol 2002;41(1):94-100.16. Villers A., Mcneal J.E., Freiha F.S. et al. Invasion of Denonvilliers' fascia in radical prostatectomy specimens. J Urol 1993;149:793.Villers A., Mcneal J.E., Freiha F.S. et al. Invasion of Denonvilliers' fascia in radical prostatectomy specimens. J Urol 1993;149:793.17. Stolzenburg J.-U., Schwalenberg T., Horn L.-C. et al. Anatomical landmarks of radical prostatectomy. Eur Urol 2007;51:629-39.Stolzenburg J.-U., Schwalenberg T., Horn L.-C. et al. Anatomical landmarks of radical prostatectomy. Eur Urol 2007;51:629-39.18. Коган М.И., Лоран О.Б., Петров С.Б. Радикальная хирургия рака предстательной железы. М.: ГЭОТАР-Медиа, 2006.Коган М.И., Лоран О.Б., Петров С.Б. Радикальная хирургия рака предстательной железы. М.: ГЭОТАР-Медиа, 2006.19. Пушкарь Д.Ю., Раснер П.И. Диагностика и лечение локализованного рака предстательной железы. М.: МЕДпресс-информ, 2008.Пушкарь Д.Ю., Раснер П.И. Диагностика и лечение локализованного рака предстательной железы. М.: МЕДпресс-информ, 2008.20. Хатьков И.Е., Волков Т.В., Биктимиров Р.Г. Лапароскопическая радикальная простатэктомия. М.: МИА 2007.Хатьков И.Е., Волков Т.В., Биктимиров Р.Г. Лапароскопическая радикальная простатэктомия. М.: МИА 2007.21. Endoscopic extraperitoneal radical prostatectomy laparoscopic and robotassisted surgery. J.U. Stolzenburg, M.T. Gettman, L.N. Evangelos eds. Springer-Verlag Berlin Heidelberg, 2007.Endoscopic extraperitoneal radical prostatectomy laparoscopic and robotassisted surgery. J.U. Stolzenburg, M.T. Gettman, L.N. Evangelos eds. Springer-Verlag Berlin Heidelberg, 2007.22. Guillonneau B., Vallancien G. Laparoscopic radical prostatectomy: the Montsouris technique. J Urol 2000;163:1643-9.Guillonneau B., Vallancien G. Laparoscopic radical prostatectomy: the Montsouris technique. J Urol 2000;163:1643-9.23. Guillonneau B., Rozet F., Cathelineau X. et al. Perioperative complications of laparoscopic radical prostatectomy: the Montsouris 3-year experience. J Urol 2002;167:51.Guillonneau B., Rozet F., Cathelineau X. et al. Perioperative complications of laparoscopic radical prostatectomy: the Montsouris 3-year experience. J Urol 2002;167:51.