To study the clinical effect of different approaches of laparoscopic radical resection(LRP) in the treatment of men with prostate cancer(PCa).Methods  A total of 92 PCa patients admitted to our hospital from January 2014 to December 2017 were selected and divided into the peritoneal group and the extraperitoneal group,46 cases in each group.Transperitoneal approach LRP was performed in the peritoneal group and extraperitoneal approach LRP was performed in the extraperitoneal group. Two groups of operation and recovery index, preoperative and postoperative 7 d serum Insulin-like growth factor I(IGF-I),vascular endothelial growth factor (VEGF), free Prostate specific antigen (fPSA),total Prostate specific antigen (tPSA),fPSA/tPSA(FPSAR) tumor related factors, such as level of preoperative and postoperative erectile function 1,6 months,1,6 months after urinary control function, complications and recurrence of postoperative 1 year were observed. Results  The intraoperative blood loss, operation time, postoperative gastrointestinal function recovery time,urinary catheter indwelling time and hospitalization time in the extraperitoneal group were all lower than those in the peritoneal group(P<0.05).Seven days after the operation,IGF-I,VEGF,fPSA,tPSA levels were reduced and FPSAR levels were increased in both groups(P<0.05),but there was no difference in IGF-I,VEGF,fPSA,tPSA,FPSAR levels between the two groups(P>0.05).At 1 and 6 months after surgery, the ⅡEF-5 scores of the extraperitoneal group were higher than those of the peritoneal group, and the urinary control function was better than that of the peritoneal group(P<0.05).There was no difference in the incidence of complications and recurrence rate at 1 year after surgery between the two groups(P>0.05).Conclusions  Both the intraperitoneal and extraperitoneal approaches can effectively remove PCa patients' lesions, reduce the level of serum tumor-related factors, and the incidence of complications is consistent with the recurrence rate 1 year after surgery.However,in the extraperitoneal group,LRP has advantages of less trauma,less impact on erections and urinary control function,and faster postoperative recovery.