Effect of modified extraperitoneal laparoscopic total intrafascial radical prostatectomy on clinical efficacy for prostate cancer patients

The effective surgical treatments of localized prostate cancer patients were explored. 90 prostate cancer patients admitted to our hospital were selected as study subjects. They were divided into research (treated by modified extraperitoneal total intrafascial laparoscopic radical prostatectomy) and control (treated by extraperitoneal laparoscopic radical prostatectomy) groups by random number table method, having 45 cases each. The operation time, bleeding volume, drainage time, hospitalization time, vascular endothelial stimulation index, urinary control function, erectile function, complications, and recurrence were monitored and compared. No significant difference was found between the two groups in clinical operation related indexes. On 3rd and 7th days after operation, VEGF (Vascular Endothelial Growth Factor) and IGF-I (Insulin-like Growth Factor 1) in research group were lower than those in control (p < 0.005). The urine control rate and erectile function normal rate in research group were higher than those in control (p < 0.005). Modified extraperitoneal laparoscopic total intrafascial radical prostatectomy reduced the degrees of trauma and irritation in the operation of prostate cancer patients. Moreover, during the observation period, it improved the postoperative urinary control and erectile function of patients and reduced the complications. Thus, this method has the worth of clinical promotion and application.

Improvement; Extraperitoneal laparoscopy; Total intrafascial radical prostatectomy; Prostate cancer; Clinical efficacy

[1] Lantz A, Bock D, Akre O, Angenete E, Bjartell A, Carlsson S, et al. Functional and oncological outcomes after open versus robot-assisted laparoscopic radical prostatectomy for localised prostate cancer: 8-year follow-up. European Urology. 2021; 80: 650–660.

[2] Panebianco V, Villeirs G, Weinreb JC, Turkbey BI, Margolis DJ, Richenberg J, et al. Prostate magnetic resonance imaging for local recurrence reporting (PI-RR): international consensus-based guidelines on multiparametric magnetic resonance imaging for prostate cancer recurrence after radiation therapy and radical prostatectomy. European Urology Oncology. 2021; 4: 868–876.

[3] Baumann FT, Reimer N, Gockeln T, Reike A, Hallek M, Ricci C, et al. Supervised pelvic floor muscle exercise is more effective than unsupervised pelvic floor muscle exercise at improving urinary incontinence in prostate cancer patients following radical prostatectomy—a systematic review and meta-analysis. Disability and Rehabilitation. 2022; 44: 5374–5385.

[4] Lestingi JFP, Guglielmetti GB, Trinh Q, Coelho RF, Pontes J, Bastos DA, et al. Extended versus limited pelvic lymph node dissection during radical prostatectomy for intermediate- and high-risk prostate cancer: early oncological outcomes from a randomized phase 3 trial. European Urology. 2021; 79: 595–604.

[5] Tilki D, Chen M, Wu J, Huland H, Graefen M, Wiegel T, et al. Adjuvant versus early salvage radiation therapy for men at high risk for recurrence following radical prostatectomy for prostate cancer and the risk of death. Journal of Clinical Oncology. 2021; 39: 2284–2293.

[6] Avda Y, Modai J, Shpunt I, Dinerman M, Shilo Y, Croock R, et al. Surgical outcomes in high-risk prostate cancer and salvage radical prostatectomy. The Israel Medical Association Journal. 2021; 23: 777–782.

[7] Barlow SK, Oyekunle T, Janes JL, De Hoedt AM, Aronson WJ, Kane CJ, et al. Prostate weight and prostate cancer outcomes after radical prostatectomy: results from the SEARCH cohort study. The Prostate. 2022; 82: 366–372.

[8] Gandaglia G, Mazzone E, Stabile A, Pellegrino A, Cucchiara V, Barletta F, et al. Prostate-specific membrane antigen radioguided surgery to detect nodal metastases in primary prostate cancer patients undergoing robot-assisted radical prostatectomy and extended pelvic lymph node dissection: results of a planned interim analysis of a prospective phase 2 study. European Urology. 2022; 82: 411–418.

[9] Classon J, Zamboni M, Engblom C, Alkass K, Mantovani G, Pou C, et al. Prostate cancer disease recurrence after radical prostatectomy is associated with HLA type and local cytomegalovirus immunity. Molecular Oncology. 2022; 16: 3452–3464.

[10] Meissner VH, Peter C, Ankerst DP, Schiele S, Gschwend JE, Herkommer K, et al. Prostate cancer‐related anxiety among long-term survivors after radical prostatectomy: a longitudinal study. Cancer Medicine. 2023; 12: 4842–4851.

[11] Chierigo F, Wenzel M, Würnschimmel C, Flammia RS, Horlemann B, Tian Z, et al. Survival after radical prostatectomy versus radiation therapy in high-risk and very high-risk prostate cancer. Journal of Urology. 2022; 207: 375–384.

[12] Martini A, Touzani A, Beauval JB, Ruffion A, Olivier J, Gasmi A, et al. Heterogeneity of contemporary grade group 4 prostate cancer in radical prostatectomy specimens. World Journal of Urology. 2022; 40: 2931–2937.

[13] Wen W, Luckenbaugh AN, Bayley CE, Penson DF, Shu X. Racial disparities in mortality for patients with prostate cancer after radical prostatectomy. Cancer. 2021; 127: 1517–1528.

[14] Klingenberg S, Fredsøe J, Sørensen KD, Ulhøi BP, Borre M, Jochumsen MR, et al. Recurrence rate after radical prostatectomy following primary staging of high-risk prostate cancer with (68) Ga-PSMA PET/CT. Acta Oncologica. 2022; 61: 1289–1294.

[15] Tappero S, Dell’Oglio P, Longoni M, Buratto C, Palagonia E, Scilipoti P, et al. Challenging cases in high-risk prostate cancer patients treated with Retzius-sparing robot-assisted radical prostatectomy. World Journal of Urology. 2022; 40: 1993–1999.

[16] van Dijk-de Haan MC, Boellaard TN, Tissier R, Heijmink SWTPJ, van Leeuwen PJ, van der Poel HG, et al. Value of different magnetic resonance imaging-based measurements of anatomical structures on preoperative prostate imaging in predicting urinary continence after radical prostatectomy in men with prostate cancer: a systematic review and meta-analysis. European Urology Focus. 2022; 8: 1211–1225.

[17] Würnschimmel C, Wenzel M, Chierigo F, Flammia RS, Tian Z, Saad F, et al. External beam radiotherapy and radical prostatectomy are associated with better survival in Asian prostate cancer patients. International Journal of Urology. 2022; 29: 17–24.

[18] Goldenthal SB, Reimers MA, Singhal U, Farha M, Mehra R, Piert M, et al. Prostate cancer with peritoneal carcinomatosis: a robotic-assisted radical prostatectomy-based case series. Urology. 2022; 167: 171–178.

[19] So J, Grageda M, Choy B, Paner G. Prostate cancer: a presentation of clinicopathologic prognosticators among Filipino and American men at radical prostatectomy. Asian Journal of Andrology. 2021; 23: 516.

[20] Hasegawa M, Yamada K, Shigeta K, Yuzuriha S, Kawakami M, Kim H, et al. How long should urologists observe patients with prostate cancer after radical prostatectomy? Weibull analysis. International Journal of Urology. 2022; 29: 304–308.

[21] Park J, Rho MJ, Moon HW, Park YH, Kim C, Jeon SS, et al. Prostate cancer trajectory-map: clinical decision support system for prognosis management of radical prostatectomy. Prostate International. 2021; 9: 25–30.

[22] van Riel LAMJG, Geboers B, Kabaktepe E, Blazevski A, Reesink DJ, Stijns P, et al. Outcomes of salvage radical prostatectomy after initial irreversible electroporation treatment for recurrent prostate cancer. BJU International. 2022; 130: 611–618.

[23] Li C, Zhang M, Wang J, Zhang X. Author correction: the 45-month therapy outcomes of permanent seed implantation and radical prostatectomy for prostate cancer patients. Investigational New Drugs. 2022; 40: 1164–1164.

[24] Tahra A, Sen UT, Sobay R, İnkaya A, Kucuk EV, Boylu U. Comparison of Retzius-sparing versus standard robot-assisted radical prostatectomy for prostate cancer. Actas UrolóGicas EspañOlas. 2022; 46: 293–300.

[25] Wang F, Fan Y, Yin X, Qi L, Ma G, Yuan Q. Prognostic comparison between radical prostatectomy and radiotherapy in prostate cancer patients at different stages and ages. Aging. 2021; 13: 16773–16785.

[26] Zeng J, Zhou S, Luan W, Du Y, Wu J. Symptom trajectories and influencing factors of prostate cancer following radical prostatectomy in Chinese patients. Annals of Palliative Medicine. 2021; 10: 7747–7758.

[27] Pasalic D, Barocas DA, Wallis CJD, Huang L, Zhao Z, Koyama T, et al. Patient-reported outcomes after external beam radiotherapy with low dose rate brachytherapy boost vs. radical prostatectomy for localized prostate cancer: five-year results from a prospective comparative effectiveness study. Journal of Urology. 2023; 209: 450–450.

[28] Callejas MF, Klein EA, Truong M, Thomas L, McKenney JK, Ghai S. Detection of clinically significant index prostate cancer using micro-ultrasound: correlation with radical prostatectomy. Urology. 2022; 169: 150–155.

[29] Oake JD, Shiff B, Harasemiw O, Tangri N, Ferguson TW, Bhindi B, et al. The comparative outcomes of radical prostatectomy versus radiotherapy for nonmetastatic prostate cancer: a longitudinal, population-based analysis. Journal of Urology. 2022; 208: 846–854.

[30] Preisser F, Würnschimmel C, Pose RM, Heinze A, Steuber T, Michl U, et al. Concordance of biopsy and pathologic ISUP grading in salvage radical prostatectomy patients for recurrent prostate cancer. The Prostate. 2022; 82: 254–259.