metricas
covid
Buscar en
Actas Urológicas Españolas (English Edition)
Toda la web
Inicio Actas Urológicas Españolas (English Edition) Comparative study between laparoscopic extraperitoneal and open adenomectomy
Journal Information
Vol. 36. Issue 2.
Pages 110-116 (February 2012)
Share
Share
Download PDF
More article options
Visits
1831
Vol. 36. Issue 2.
Pages 110-116 (February 2012)
Surgical technique
Comparative study between laparoscopic extraperitoneal and open adenomectomy
Estudio comparativo entre adenomectomía extraperitoneal laparoscópica y abierta
Visits
1831
A. García-Segui
Corresponding author
agarciasegui@gmail.com

Corresponding author.
, M. Gascón-Mir
Servicio de Urología, Hospital General Mateu Orfila, Mahón, Menorca, Spain
This item has received
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (3)
Show moreShow less
Tables (3)
Table 1. Clinical, perioperative, and follow-up parameters.
Table 2. Comparative series between open surgery and laparoscopic adenomectomy.
Table 3. Laparoscopic adenomectomy, ‘finger-assisted’ laparoscopic adenomectomy, and robotic adenomectomy series.
Show moreShow less
Additional material (1)
Abstract
Objectives

In spite of the development of endoscopic techniques, open adenomectomy continues to be the treatment of choice for large adenomas. Laparoscopic and robotic adenomectomies provide good results in specialized centers.

The experience acquired with laparoscopic extraperitoneal adenomectomy (LEA) in a regional center is presented to evaluate its results and compare them prospectively with the results of open surgery.

Patients and methods

46 patients with benign prostatic hyperplasia (BPH) (prostate >80g) and an indication for surgery were evaluated. The first 11 patients underwent LEA and were not included in the comparison. Thereafter, the cases were compared; 17 patients underwent LEA and 18, open surgery. In the extraperitoneal technique with 4 trocars, enucleation was performed with an ultrasonic scalpel.

Results

There were no significant differences between groups in age, prostate volume, uroflow (Qmax), International Prostate Symptom Score (IPSS), and Quality of Life scale (QoLs). The operation time was significantly greater in the LEA group (135.2min vs. 101.2min, p=0.022). Intraoperative bleeding (250ml vs. 493.3ml, p=0.004), irrigation time (22.2h vs. 39.1h, p=0.038), catheter indwelling time (5.5 days vs. 7.5 days, p=0.030), hospital stay (3.7 days vs. 6.6 days, p=0.006) and transfusion rate (0% vs. 22.2%) were significantly lower in the laparoscopy group. There was a greater incidence of hemorrhagic and surgical wound complications in the open surgery group.

Conclusions

LEA is a relatively complex technique that requires laparoscopic skills, but it is a feasible and safe alternative to open surgery and has several advantages.

Keywords:
Laparoscopic adenomectomy
Simple laparoscopic prostatectomy
Benign prostatic hyperplasia
Resumen
Objetivos

A pesar del desarrollo de las técnicas endoscópicas, la adenomectomía abierta sigue siendo el tratamiento de elección para grandes adenomas. La adenomectomía laparoscópica y robótica reporta buenos resultados en centros especializados. Presentamos la experiencia en nuestra institución comarcal con la adenomectomía laparoscópica extraperitoneal (ALE) para evaluar sus resultados y compararlos prospectivamente con cirugía abierta.

Pacientes y métodos

Cuarente y seis pacientes con hiperplasia prostática benigna (HPB) (próstatas >80 g) con indicación de cirugía fueron evaluados. A los primeros 11 pacientes se les realizó ALE y no fueron incluidos en la comparación. Los siguientes casos fueron comparados: 17 pacientes fueron sometidos a ALE y 18 a cirugía abierta. En la técnica extraperitoneal con 4 trócares se realiza la enucleación con bisturí ultrasónico.

Resultados

No hubo diferencias significativas entre los grupos con respecto a la edad, el volumen prostático, el uroflujo (Qmáx), la escala internacional de síntomas protáticos (IPSS) y la escala de calidad de vida (QoLs). El tiempo operatorio fue significativamente mayor en el grupo de ALE (135,2 vs. 101,2 minutos; p = 0,022). El sangrado intraoperatorio (250 vs. 493,3ml, p = 0,004), el tiempo de irrigación (22,2 vs. 39,1 horas; p = 0,038), el tiempo de permanencia de la sonda (5,5 vs. 7,5 días; p = 0.030), la estancia hospitalaria (3,7 vs. 6,6 días; p = 0,006) y la tasa de transfusiones (0 vs. 22,2%) fueron significativamente menores en el grupo de laparoscopia. Hubo una mayor incidencia de complicaciones hemorrágicas y de la herida quirúrgica en el grupo de cirugía abierta.

Conclusiones

ALE es una técnica de relativa complejidad que requiere de destrezas laparoscópicas, pero es una alternativa factible y segura a la cirugía abierta con múltiples beneficios.

Palabras clave:
Adenomectomía laparoscópica
Prostatectomía simple laparoscópica
Hiperplasia prostática benigna

Article

These are the options to access the full texts of the publication Actas Urológicas Españolas (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Actas Urológicas Españolas (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos