MEDLINE Journals

    Laparoscopic pelvic lymph node dissection for staging of prostatic cancer.

    Authors
    Doublet JD, Gattegno B, Thibault P 
    Source
    Eur Urol 1994; 25(3) :194-8.
    Abstract

    Assessment of the pelvic lymph node status is a major concern in prostatic cancer staging. In spite of a normal abdominopelvic CT scan examination in patients with organ-confined disease, 7-30% will have lymph node metastases at pathological examination and will not benefit from radical prostatectomy. Laparoscopy enables pelvic lymph node dissection via a minimally invasive approach. Twenty-nine patients underwent laparoscopic pelvic lymph node dissection (LPLND) for prostatic cancer staging. The average duration of the bilateral dissection was 90 +/- 40 min (range 35-180 min). One patient died of a stroke on postoperative day 1, without local complication. The peroperative complications were 1 injury of the external iliac vein, 1 ileal injury, 1 ureteral injury, all 3 (11%) requiring immediate or delayed laparotomy. One patient had a self-resolving bilateral obturator nerve paresis. A previously irradiated patient had perineal lymphedema for 4 weeks. The average number of lymph nodes removed was 8.4 +/- 3.4 (range 4-17) for bilateral LPLND. Five patients had lymph node metastases. The median length of stay for patients undergoing LPLND as a single procedure was 2 days (range 2-11 days). After an operational period, during which the complication rate was relatively high, we now consider LPLND as a safe and effective procedure for the staging of patients with organ-confined prostatic cancer, but considering the increased risk of complications during the application period, we do not encourage the generalization of this technique which should remain restricted to some particular strategies, as in combination with perineal radical prostatectomy.

    Mesh
    Aged
    Humans
    Intraoperative Complications
    Laparoscopy
    Length of Stay
    Lymph Node Excision
    Lymph Nodes
    Lymphatic Metastasis
    Male
    Neoplasm Staging
    Postoperative Complications
    Prostatic Neoplasms
    Time Factors
    Language

    eng

    Pub Type(s)
    Journal Article
    PubMed ID

    8200400

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