TRANSPERITONEAL LAPAROSCOPIC RADICAL PROSTATECTOMY VERSUS EXTRAPERITONEAL LAPAROSCOPIC RADICAL PROSTATECTOMY

Abstract

Prostate cancer is the second most common malignancy in the world among men and several techniques are available for performing prostatectomy. Objectives: To compare transperitoneal laparoscopic radical prostatectomy compared to extraperitoneal laparoscopic radical prostatectomy. Materials and methods: This is an integrative review, in which the guiding question was “Does transperitoneal laparoscopic radical prostatectomy have advantages when compared to extraperitoneal laparoscopic radical prostatectomy?”. The search for articles occurred in the PubMed database using the terms “transperitoneal”, “extraperitoneal” and “prostatectomy”, combined with Boolean operators. Results and discussion: In terms of perioperative characteristics, the transperitoneal approach presented shorter overall operative time, less blood loss and shorter hospital stay. Urinary continence was comparable between extraperitoneal and transperitoneal methods at 3 and 24 months after surgery, but lower at 12 months in the extraperitoneal group. At 3 months, the transperitoneal group had better sexual performance with penile penetrance. Perioperative complications were evaluated in the early and late periods after the surgeries. Early complications were not different between groups, while late complications were significantly lower in the transperitoneal group. Positive surgical margin rates were lower in the transperitoneal approach group. Biochemical recurrence occurred in 36.3% in the extraperitoneal approach group and 27.6% in the transperitoneal approach group. Conclusion: We concluded from our study that transperitoneal laparoscopic radical prostatectomy was superior to extraperitoneal radical prostatectomy.