PD-06.12

PODIUM SESSIONS

large incision. In some centers partial adenalectomy has been performed. Material: We analysed results after 44 adrenalectomies (7.7% of our total laparoscopic material). 31 procedures were performed retroperitoneally and 13 transperitoneally. In 26 patients we operated on the right side and in 18 of them on the left side. Operations were performed using 3 or 4 trocars. In 9 patients we performed organ-sparing tumorectomy in order to preserve the function of adrenal gland. Method: Prior to the procedure, apart from laboratory tests we performed additional examinations: abdominal ultrasound, urography and computerised tomography. During the operations patients were under general anaesthesia, in lateral recumbent position (retroperitoneally) or lying on the back (transperitoneally). The working space in retroperitoneum was created with the Gaur balloon and in peritoneal cavity with CO2 insufflation. The preparation in the area of the upper end of the kidney enabled access to the adrenal gland. Adrenal vessels were coagulated or clipped and cut. In 9 cases when the tumor was localized laterally it was enucleated from the capsula. The operations lasted for 85-270 min. Total amount of blood loss did not exceed 250 ml. Microscopic examination of the excised glands revealed the presence of adrenal adenoma in 39 cases and carcinoma of adrenal gland in 5 patients. Patients were discharged on the 3rd or 4th postoperative day. Conclusion: Laparoscopic retroperitoneal or transperitoneal adrenalectomy is an effective and low-invasive procedure. Adrenal-sparing tumorectomy enables us to preserve the function of the adrenal gland. PD-06.12 Experience of retroperitoneal laparoscopic surgery with 1560 cases at a single institution Li M, Zhou L, Li N, Na Y Department of Urology, First Hospital, Institute of Urology, Peking University, China Introduction: Retroperitoneal approaches are widely used as laparoscopic procedures in management of urological disorders. We developed an easy technique for establishing retroperitoneal cavity and performing dissection during the operation. Methods: From Jan. 2000 to March 2006, 1560 patients underwent retroperitoneal laparoscopic surgery, including 469 adrenalectomies, 448 radical ne-

Table 1. PD-06.12 Nephrectomy

Adrenalectomy

Cyst operation

OP BL Catheter OP BL Catheter OP BL Catheter (min) (ml) (day) (min) (ml) (day) (min) (ml) (day) Uninjured 50–190 50–1000 1–3 30–150 50–500 1–3 20–80 50–150 1–3 Average 88 120 2.2 58 85 1.2 35 50 2 Injured 90–210 80–2600 1–11 30–210 50–400 1–3 30–100 50–300 1–3 Average 132 258 2.3 70 105 1.5 48 88 2 Table 2. PD-06.12 First 780 cases Average Last 780 cases Average

OP (min) 30–210 90 20–190 65

BL (ml) 50–2600 350 50–1200 160

Organ injury 8 (1.03%)

Peritoneal injury 287 (36.8%)

2 (0.26%)

140 (18.0%)

phrectomies, 34 heminephrectomies, 258 nephreureterectomies, 55 pyeloplasties, 28 ureteral surgeries, and 268 renal cyst operations. 871 were male, 689 female; age 19-79 (average 54.2). The modified easy technique (working ports as V-configuration) was used for retroperitoneal cavity and safe dissection during whole operation. Results: We experienced more difficult performance and blood loss during the operation in patients with injured peritoneum (427 cases) than those with uninjured peritoneum (1133 cases) (Table 1). We compared the first 780 cases with last 780 cases for operation time, blood loss, intraoperative complications including peritoneal, diaphragm, spleen, pancreas injury and hospital stay in Table 2. Conclusion: An injured peritoneum allows the gas flow into peritoneal cavity. The retroperitoneal cavity will be pressed, which raises the difficulty of operation, increases operation time, blood loss and intraoperative complications. To keep peritoneum uninjured is the warrant for a wide satisfied retroperitoneal cavity. A well-trained and experienced surgeon is the warrant for reducing operation time and complications.

PD-07: Prostate Cancer 2 Tuesday, November 14 13:30-15:30 PD-07.01 Incidence of bladder outlet obstruction after primary treatment for prostate cancer: data from CaPSURE

UROLOGY 68 (Supplement 5A), November 2006

Hospital stay 3–14 7.6 3–8 5.4

Elliott S1, Meng M2, Elkin E2, McAninch J2, DuChane J3, Carroll P2 1 University of Minnesota, Minneapolis, MN, USA; 2University of California San Francisco, San Francisco, CA, USA; 3TAP Pharmaceutical Products, Inc., Lake Forest, IL, USA Introduction: Bladder outlet obstruction (BOO) is a known complication of treatment for prostate cancer (CaP). Reported rates of BOO vary greatly depending on treatment modality, patient population and method of data collection (patientreported vs. physician-reported). We sought to determine the incidence of iatrogenic BOO after primary treatment for clinically localized CaP in a population of primarily community-treated men. Methods: 5,630 men with newly diagnosed, localized CaP and no history of urethral stricture disease were identified in the CaPSURE database. Patients treated with radical prostatectomy (RP), external beam radiotherapy (EBRT), brachytherapy (BT), cryotherapy, androgen deprivation therapy (ADT), RP⫹EBRT, BT⫹EBRT or watchful waiting (WW) were included. The database was queried for a patientreported history or ICD-9 and CPT codes consistent with a diagnosis of or treatment for urethral stricture disease, bladder neck contracture or prostatic obstruction after CaP therapy. Time to obstruction was examined by KaplanMeier method. Risk factors for the development of BOO were examined in a multivariate Cox proportional hazards model. Results: The incidence of BOO was 441 (7.8%, range by treatment type of 6-16%), with a median follow-up of 2 years (09.8). In the multivariate model, primary treatment type (p⫽0.007), household income (p⫽0.0004), body mass index (p⫽0.005), history of urinary conditions

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