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Continuous (N=26). Interrupted (N=27). P value. Bladder N. e. c. k Contracture. 4. (15.4%). 1 (3. 7. %). 0.01. 7. Urine Leak. 4 (15.4%) . 3 (11.1%). 0. 84. No. 096. Comparative outcomes of continuous and interrupted v esico -urethral a nastomosis during l aparoscopic

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Comparative outcomes of continuous and interrupted

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Comparative outcomes of continuous and interrupted

Continuous (N=26)

Interrupted (N=27)

P value

Bladder N

e

c

k Contracture

4

(15.4%)

1 (3.

7

%)

0.01

7

Urine Leak

4 (15.4%)

3 (11.1%)

0.

84

No. 096

Comparative outcomes of continuous and interrupted

vesico-urethral anastomosis during laparoscopic

radical prostatectomy

Andrew Chong1, Daniel Steiner1, Steven Chan2, Jason Ooi1

1Western Health Department of Urology

2Professor, Western Health Department of Surgery

Posters Proudly Supported by:

Introduction

Laparoscopic Radical Prostatectomy (LRP) is an accepted technique for the management of localised prostate cancer which delivers similar oncological and functional outcomes to the open procedure1. The vesico-urethral anastomosis is a critical step of the operation and an important determinant of long term functional outcomes. Several methods of performing the anastomosis have been described, however none have clearly been shown to be superior2.

Results

Pre-operative data

Aim

To report functional outcomes and complication rates between patients receiving interrupted and continuous anastomosis during laparoscopic radical prostatectomy

Peri/Post-operative data

Primary Outcomes

  • Methods

  • Retrospective review of 53 LRP cases at Western Health from 2008 to 2012

  • 3 surgeons performed continuous anastomosis (CA, N=26) with standard Van Velthoven reconstruction, 1 surgeon performed interrupted anastomosis (IA, N=27)

  • Patient and disease variables were recorded from both groups: Age, BMI, PSA, prostate volume, pathological stage, Gleason score

  • Outcomes measured: Bladder neck contracture, continence and anastomotic leak rates, operative time, length of stay

  • Statistical analysis: Fisher’s exact test for categorical data, Mann-Whitney U test for interval scale data, time to event analysis to compare operative times

*all cases required operative management

  • Conclusions

  • Continuous anastomosis during LRP associated with increased incidence of bladder neck contracture

  • Better early continence observed in patients receiving interrupted anastomosis

  • No difference in long term continence with either method

  • Equivalent urine leak rates observed

  • Acknowledgements

  • Mr Daniel Steiner

  • Mr Jason Ooi

  • Mr Raymond Tong

  • Professor Steven Chan

References

1 EurUrol 2009 May;55(5):1037-63 Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies. FicarraV

2 World J Urol (2008) 26:617–622 Analysis of three different vesicourethral anastomotic techniques in laparoscopic radical prostatectomy. Teberet al.


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