European Urology
Radical Retropubic Prostatectomy Using Endoscopic Gastrointestinal Anastomosis StaplersMuto G.a · Bardari F.a · Bozzo R.b · Comi L.b · Moroni M.b · Leggero R.a · Coppola P.aaDepartment of Urology, Giovanni Bosco Hospital, and bDepartment of Urology, Maria Vittoria Hospital, Turin, Italy
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Article / Publication Details
Published online: February 16, 2001
Issue release date: January 2001
Number of Print Pages: 4
Number of Figures: 0
Number of Tables: 2
ISSN: 0302-2838 (Print)
eISSN: 1873-7560 (Online)
For additional information: https://www.karger.com/EUR
Abstract
Objective: To investigate whether the use of the endoscopic gastrointestinal anastomosis (GIA) stapler for hemostasis of the dorsal vein complex during radical retropubic prostatectomy saves operation time and blood loss together with therapeutic efficacy. Materials and Methods: From April 1990 to December 1998, a total of 296 patients underwent radical retropubic prostatectomy for prostate cancer in clinical stages T1, T2 and T3. In 157 patients we evaluated the efficacy of the endoscopic GIA stapler in order to minimize blood loss from the dorsal vein complex and to reduce mean operative time. Results: The mean total operative time decreased an average of 35 min and the mean blood loss fell from 850 to 400 cm3 using the stapling technique. Although complications are seen with traditional methods, we noted a net increase in anastomotic strictures with this new technique. Conclusions: Even if this technical trick is effective in reducing blood loss, a higher incidence of anastomotic strictures has to be taken into account when using staplers close to the anastomotic site.
© 2001 S. Karger AG, Basel
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References
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Article / Publication Details
Published online: February 16, 2001
Issue release date: January 2001
Number of Print Pages: 4
Number of Figures: 0
Number of Tables: 2
ISSN: 0302-2838 (Print)
eISSN: 1873-7560 (Online)
For additional information: https://www.karger.com/EUR
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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PubMed IDL. Boccon-Gibod, Paris
On the basis of a nonrandomized retrospective study, the authors show that during radical retropubic prostatectomy the use of the endoscopic GIA stapler may be a useful adjunct to control the dorsal vein complex.
However, the marked reduction in blood loss is associated with a very significant increase in the incidence of vesicourethral strictures.
If at first sight this trick appears to be a simple way to bypass a significant technical problem, its wide use should certainly not be encouraged. On the contrary meticulous dissection of the endopelvic fascia, fibrous structures and dorsal vein complex overlying the membranous urethra and external sphincter should lead to a safe and minimally hemorrhagic division of the dorsal vein complex preserving not only the external sphincter, but also the membranous urethra, allowing a water-tight vesicourethral anastomosis and avoiding the risk of vesicourethral stricture and incontinence.
