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Extended pelvic lymph node dissection in robotic-assisted radical prostatectomy: surgical technique and initial experience.
Urology. 2010 May; 75(5):1199-204.U

Abstract

OBJECTIVES

To describe, and show in the accompanying video segments, a technique for extended pelvic lymph node dissection (ePLND) in robotic-assisted radical prostatectomy (RARP) and report our clinicopathologic and perioperative outcomes. The extent of pelvic lymphadenectomy during radical prostatectomy has not been standardized. However, evidence demonstrates that an ePLND yields a greater number of positive nodes.

METHODS

A total of 32 patients with clinically localized prostate cancer underwent RARP with ePLND by a single surgeon (J.C.) between January and August 2008. The template for the ePLND included the obturator, hypogastric, external iliac, and common iliac lymph nodes up to the bifurcation of the aorta. Systematic review and grading of adverse events were performed.

RESULTS

The median number of lymph nodes retrieved was 18 (interquartile range [IQR] 12-28). Four patients (12.5%) had lymph node metastases. Of the 4 patients with lymph node metastases, 1 patient (25%) had the involved lymph node exclusively in the common iliac region. Median operative time for the ePLND was 72 minutes (IQR 66-86). Median hospital length of stay was 2.0 days (IQR 2.0-2.8). Graded complications included 13 grade 1 events and 1 grade 2 event, with 1 grade 1 event being considered related to ePLND. No clinically presenting lymphoceles or thrombotic events were encountered.

CONCLUSIONS

An ePLND during RARP is technically feasible and appears to have minimal morbidity. It produces a high lymph node yield and may result in improved pathologic staging.

Authors+Show Affiliations

Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. yeed1@mskcc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20163838

Citation

Yee, David S., et al. "Extended Pelvic Lymph Node Dissection in Robotic-assisted Radical Prostatectomy: Surgical Technique and Initial Experience." Urology, vol. 75, no. 5, 2010, pp. 1199-204.
Yee DS, Katz DJ, Godoy G, et al. Extended pelvic lymph node dissection in robotic-assisted radical prostatectomy: surgical technique and initial experience. Urology. 2010;75(5):1199-204.
Yee, D. S., Katz, D. J., Godoy, G., Nogueira, L., Chong, K. T., Kaag, M., & Coleman, J. A. (2010). Extended pelvic lymph node dissection in robotic-assisted radical prostatectomy: surgical technique and initial experience. Urology, 75(5), 1199-204. https://doi.org/10.1016/j.urology.2009.06.103
Yee DS, et al. Extended Pelvic Lymph Node Dissection in Robotic-assisted Radical Prostatectomy: Surgical Technique and Initial Experience. Urology. 2010;75(5):1199-204. PubMed PMID: 20163838.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extended pelvic lymph node dissection in robotic-assisted radical prostatectomy: surgical technique and initial experience. AU - Yee,David S, AU - Katz,Darren J, AU - Godoy,Guilherme, AU - Nogueira,Lucas, AU - Chong,Kian Tai, AU - Kaag,Matthew, AU - Coleman,Jonathan A, Y1 - 2010/02/16/ PY - 2009/05/04/received PY - 2009/06/18/revised PY - 2009/06/26/accepted PY - 2010/2/19/entrez PY - 2010/2/19/pubmed PY - 2010/6/4/medline SP - 1199 EP - 204 JF - Urology JO - Urology VL - 75 IS - 5 N2 - OBJECTIVES: To describe, and show in the accompanying video segments, a technique for extended pelvic lymph node dissection (ePLND) in robotic-assisted radical prostatectomy (RARP) and report our clinicopathologic and perioperative outcomes. The extent of pelvic lymphadenectomy during radical prostatectomy has not been standardized. However, evidence demonstrates that an ePLND yields a greater number of positive nodes. METHODS: A total of 32 patients with clinically localized prostate cancer underwent RARP with ePLND by a single surgeon (J.C.) between January and August 2008. The template for the ePLND included the obturator, hypogastric, external iliac, and common iliac lymph nodes up to the bifurcation of the aorta. Systematic review and grading of adverse events were performed. RESULTS: The median number of lymph nodes retrieved was 18 (interquartile range [IQR] 12-28). Four patients (12.5%) had lymph node metastases. Of the 4 patients with lymph node metastases, 1 patient (25%) had the involved lymph node exclusively in the common iliac region. Median operative time for the ePLND was 72 minutes (IQR 66-86). Median hospital length of stay was 2.0 days (IQR 2.0-2.8). Graded complications included 13 grade 1 events and 1 grade 2 event, with 1 grade 1 event being considered related to ePLND. No clinically presenting lymphoceles or thrombotic events were encountered. CONCLUSIONS: An ePLND during RARP is technically feasible and appears to have minimal morbidity. It produces a high lymph node yield and may result in improved pathologic staging. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/20163838/Extended_pelvic_lymph_node_dissection_in_robotic_assisted_radical_prostatectomy:_surgical_technique_and_initial_experience_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(09)02350-4 DB - PRIME DP - Unbound Medicine ER -