Prostatectomia radical laparoscópica versus aberta: margens cirúrgicas

Laparoscopic radical prostatectomy has become an accepted alternative to open surgery. Our goal is to compare the oncological outcome of both approaches. The prospective study was initiated in September 2012, during 10 months. The high risk tumors were excluded from the study, only low and intermediate risk were included. We evaluated the following parameters: age, PSA, biopsy Gleason score, operative time, blood units, surgical margins, complications, Gleason score and TNM stage of the surgical specimen. Within 10 months, 45 patients underwent radical prostatectomy. 24 underwent laparoscopic approach and 21 the open approach. In the laparoscopic group, 70.8% (17) presented negative margins, 25% (6) positive margins and 4.17% (1) not suitable for classification. In the open approach 66.7% (14) presented negative margins, 28.6% (6) presented positive margins and 4.76% (1) not suitable for classification. It was used a Chi-Square Test considering positive and negative margins. No statistically differences were found (p value = 0.79). We evaluated the distribution of the different tumor stages T2a, T2b, T2c, T3a and T3b (TNM) in both groups. No difference was found in the distribution of the tumor stages in both groups. We have used a chi-square test (p value = 0.23). There is no association between the margins and the surgical approaches, and no association between the tumor stages and the two surgical approaches. We can conclude that the laparoscopic approach can be an alternative in low and intermediate risk cancers, even in low volume centres. © 2014 Associação Portuguesa de Urologia. Published by Elsevier España, S.L.U. All rights reserved