Optimal Surgical Management of the Obese Man With Prostate Cancer: Laparoscopic or Perineal Radical Prostatectomy

[摘要] Radical prostatectomy is one of the most common treatments for prostate cancer. It was originally described via a perineal approach over 100 years ago by Hugh Hampton Young.1 However, it was not until the 1970s and early 1980s, with new detailed anatomic descriptions,2,3 that radical prostatectomy became a common treatment for prostate cancer. Prostate-specific antigen-based screening, which began in the late 1980s and early 1990s, resulted in a large pool of men with clinically localized disease who were candidates for surgical treatment. Together, these events resulted in a dramatic rise in the number of radical prostatectomies performed annually.4 In the 1990s, laparoscopic surgical approaches became more common in urological practice, particularly for renal surgery.5 Over time, it became increasingly clear that it was possible to reduce morbidity without impacting on oncological success.6 Not long thereafter the first laparoscopic radical prostatectomy was performed.7 This, in turn, heightened awareness of the need to minimize morbidity and resulted in a renewed interest in perineal prostatectomy.

[学科分类] 基础医学