Preliminary report of hybrid radical prostatectomy for prostate cancer - Less bleeding, good sight, and secure surgical margin

To evaluate morbidity in our initial series of patients who underwent hybrid radical prostatectomy (hybridized retropubic and laparoscopic radical prostatectomy, HRP). The operative and pathological outcomes obtained in 11 consecutive patients who underwent HRP from May 2006 to September 2006 were analyzed and compared with a matched cohort of 14 patients who had undergone retropubic radical prostatectomy (RRP) performed by the same surgeon between 2003 to 2005. The two groups were comparable in terms of mean pre-operative PSA. The peri-operative data included operative time, quantity of intra-operative blood loss, complications, hospitalization length, and duration of catheterization. The following pathological parameters were considered : pathological stage, and positive surgical margin rate. Operating times were comparative with both procedures. The mean operative time was 214 +/- 44 minutes for HRP and 210 +/- 31 minutes for RRP. The mean estimated blood loss was 497 +/- 312 mL for HRP and 717 +/- 298 mL for RRP. No eterologous transfusion was given for patients with HRP. An ileum injury caused by port insertion was observed in the HRP group (HRP group.). The mean post operative hospital stay was 13.3 +/- 1.5 days in the HRP group and 14.7 +/- 3.9 days in the RRP group. Catheterization time was 7.2 +/- 1.6 days in the HRP group and 6.5 +/-1.0 days in the RRP group. The surgical margin-positive rate in the HRP group was 18.2%. These preliminary results of HRP show that hybrid radical prostatectomy is safe and has the potential to reduce blood loss and decrease the positive margin ratio through a combination of the benefits of laparoscopic and open procedures.