Estudio comparativo de adenomectomía prostática laparoscópica y abierta. ¿Cuál ofrece mejores resultados?

Abstract

Background

Standard management of benign prostatic hyperplasia in large volume adenomas is open surgery. With the advent a little over a decade ago of minimally invasive techniques for prostatic adenoma, this trend is changing.

Aim

Given that there are few comparative studies establishing a real difference between open and laparoscopic surgery, the aim of our study was to objectively evaluate their advantages.

Methods

A total of 82 patients were analyzed. They were diagnosed with benign prostatic hyperplasia and were consecutively operated upon. Twenty-four of the patients underwent laparoscopic surgery and 58 had open surgery.

Results

There was significant difference in relation to patient weight (<0.001), which was greater in the laparoscopic adenomectomy group (LA). The two groups had similar results in regard to preoperative studies such as PSA, IPSS, prostate size, and uroflowmetry. The surgical indications were also similar and the most frequent indication was acute urinary retention. Surgery duration was longer in the LA group with statistical significance (127.2 vs. 90.9 min; P≤0.001) and intraoperative blood loss and transfusions were significantly lower in the LA group, based on the Clavien-Dindo classification (450 vs. 738.8 ml; P=0.009 and 0.45 vs. 0.25; P=0.039, respectively). There were no differences between the two procedures in relation to length of hospital stay, postoperative results, or complications (according to the Clavien-Dindo classification).

Conclusions

Both procedures had similar postoperative results and complications, but there was less blood loss and fewer transfusions with the laparoscopic procedure. Surgery duration was longer with the laparoscopic technique and there were no differences in relation to hospital stay.