Retrograde Extraperitoneal Laparoscopic Prostatectomy (RELP). A Prospective Study about 1,000 Consecutive Patients, with Oncological and Functional Results - Université de Lille Accéder directement au contenu
Article Dans Une Revue Urology Journal Année : 2021

Retrograde Extraperitoneal Laparoscopic Prostatectomy (RELP). A Prospective Study about 1,000 Consecutive Patients, with Oncological and Functional Results

P. Dubernard
  • Fonction : Auteur
P. Chaffange
  • Fonction : Auteur
P. Pacheco
  • Fonction : Auteur
E. Pricaz
  • Fonction : Auteur
N. Vaziri
  • Fonction : Auteur
M. Vinet
  • Fonction : Auteur
P. Chalabreysse
  • Fonction : Auteur
C. H. Rochat
  • Fonction : Auteur

Résumé

Purpose: Usual laparoscopic surgery of localized prostate cancer uses antegrade dissection. We describe and evaluate the original RELP (Retrograde Extraperitoneal Laparoscopic Prostatectomy). Materials and Methods: A prospective cohort of 1005 patients with clinical localized cancer prostate were operated from December 1999 to September 2013, in Lyon (France), and followed up to 172 months (median: 60 months). Patients encountered a RELP procedure, a totally extra-peritoneal approach with a retrograde dissection from the apex to the bladder neck, and ascending dissection of the erectile neurovascular bundles, facilitated by the 30° optic telescope. Adjunctive treatments were: immediate radiotherapy (9.2%), salvage radiotherapy (13.4%), androgen deprivation therapy (10.8%), chemotherapy (1.4%), no treatment (75.8%). Results The mean age was 63.4, the Gleason score was 4+3 or worse in 24.9%, there were 2.3% unifocal tumors. The pathology stages were pT2A (8.71%), pT2B (2.80%), pT2C (69.0%), pT3A (13.1%), and pT3B (6.41%). There were 60.8% negative margins (R0) in total (90.1% for basal locations, and 75.8% for apical locations). The mean operating time was 115 minutes for the last 100 patients. The BPFSR (biological progression free survival rate, PSA≤0.10 ng/ml) was 71.9% at 5 years, and 61.4% at 10 years. The cancer specific survival rate was 99.4% at 5 years, and 98.3% at 10 years. After 12 months, 88.6% of patients did not require an incontinence pad, and 67.0% retained the pre-operative quality of their erection. Conclusion: RELP yields good oncologic results and quality of life, as good as robot-assisted surgery.
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Dates et versions

hal-04546684 , version 1 (15-04-2024)

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Citer

P. Dubernard, P. Chaffange, P. Pacheco, E. Pricaz, N. Vaziri, et al.. Retrograde Extraperitoneal Laparoscopic Prostatectomy (RELP). A Prospective Study about 1,000 Consecutive Patients, with Oncological and Functional Results. Urology Journal, 2021, Urology Journal, 18 (5), p. 503-511. ⟨10.22037/uj.v18i.6233⟩. ⟨hal-04546684⟩

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