The effect of peritoneal opening on outcomes of extraperitoneal laparoscopic radical prostatectomy

An analysis of 255 cases

Authors

DOI:

https://doi.org/10.5489/cuaj.9402

Keywords:

Peritoneal opening, extraperitoneal laparoscopic radical prostatectomy, Complications, Clavien-Dindo

Abstract

INTRODUCTION: This study aimed to investigate the impact of peritoneal patency during extraperitoneal laparoscopic radical prostatectomy (eLR P) on perioperative and postoperative outcomes.

METHODS: Between May 2018 and March 2025, 255 patients who underwent eLR P were retrospectively evaluated. Patients without peritoneal opening were classified as group 1 (n=223), while those with peritoneal opening were classified as group 2 (n=32). Demographic data, operative time, complication rates, and complication grades based on the Clavien-Dindo classification were analyzed. Logistic regression analysis was performed to identify associated risk factors.

RESULTS: A history of abdominal surgery was significantly more common in group 2 (p<0.001) and the mean operative time was also significantly longer in this group (p<0.001). Although the overall complication rate was higher in group 2 (37.5% vs. 24.2%), the difference was not statistically significant (p=0.131). Multivariate analysis revealed that a history of abdominal surgery, operative time >180 minutes, and estimated blood loss >150 ml were significantly associated with postoperative complications; however, peritoneal opening was not identified as an independent risk factor (p=0.113).

CONCLUSIONS: Although peritoneal opening may introduce technical challenges that compromise the advantages of the extraperitoneal approach, it does not significantly affect postoperative complication rates. With sufficient surgical experience, it appears to be a manageable intraoperative event.

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Author Biographies

Burak Elmaagac, University of Health Sciences Medical Faculty of Kayseri, Kayseri City Hospital, Kayseri, Turkey

Assoc. Prof. MD, Department of Urology

Abdullah Golbasi, University of Health Sciences Medical Faculty of Kayseri, Kayseri City Hospital, Kayseri, Turkey

Assoc. Prof. MD, Department of Urology

Huseyin Bicer, University of Health Sciences Medical Faculty of Kayseri, Kayseri City Hospital, Kayseri, Turkey

MD, Department of Urology

Omer Sahin, University of Health Sciences Medical Faculty of Kayseri, Kayseri City Hospital, Kayseri, Turkey

MD, Resident, Department of Urology

Mert Ali Karadag, University of Health Sciences Medical Faculty of Kayseri, Kayseri City Hospital, Kayseri, Turkey

Prof, MD, Department of Urology

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Published

2026-01-23

How to Cite

Ozercan, A. Y., Elmaagac, B., Golbasi, A., Bicer, H., Sahin, O., & Karadag, M. A. (2026). The effect of peritoneal opening on outcomes of extraperitoneal laparoscopic radical prostatectomy: An analysis of 255 cases. Canadian Urological Association Journal, 20(5), E176–81. https://doi.org/10.5489/cuaj.9402

Issue

Vol. 20 No. 5 (2026): CUAJ May

Section

Original Research

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