March 3rd, 2010

Laparoscopic Surgery and Open Surgery Produce Similar Complication Rates in Prostate Cancer


Laparoscopic prostatectomy and open radical prostatectomy produce similar outcomes and carry similar rates of postoperative complications, according to the results of a study published in an early online version of the Journal of Urology.1

Radical prostatectomy refers to the surgical removal of the entire prostate and some surrounding tissue. Prostatectomy may be performed using traditional open surgery, in which the surgeon makes a single, long incision; or through a laparoscopic procedure (sometimes called minimally invasive surgery), in which several small incisions are made. During laparoscopy, the surgeon inserts a small video camera through one of the incisions in order to see inside the abdomen. In a variant of laparoscopic surgery known as robotic-assisted laparoscopic surgery, the surgeon sits at a console near the operating table and performs the surgery by controlling robotic arms that hold the surgical instruments.

Laparoscopic surgery has been perceived as a less invasive procedure that may preserve erectile function; however, there has been little research and no data to substantiate this claim.

A population-based study included 5,923 men aged 66 or older with localized prostate cancer. All of the men underwent radical prostatectomy between 2003 and 2005; 18% of these procedures were performed laparoscopically. After adjusting for patient and tumor characteristics, the researchers found that there were no differences in the rate of complications between the two surgeries nor were there differences in postoperative treatment with radiation or hormone therapy.

The laparoscopic procedure was associated with a 35% shorter hospital stay and a 26% lower rate of bladder neck and urethral obstruction. Patients who underwent surgery from surgeons who performed a higher volume of laparoscopic procedures tended to have shorter hospital stays and reduced chance of genitourinary and bowel complications.

The researchers concluded that laparoscopic and open prostatectomy produce similar results and similar rates of complications. Therefore, men considering prostatectomy must weigh the risks and benefits of each procedure to make an informed, personal decision.


1 Lowrance WT, Elkin EB, Jacks LM, et al. Comparative effectiveness of prostate cancer surgical treatments: A population based analysis of postoperative outcomes. Journal of Urology [early online publication]. February 25, 2010.

Tags: Early Stage I-II (A-B) Prostate Cancer, News, Prostate Cancer, Uncategorized