Extended pelvic lymph node dissection in robotic-assisted radical prostatectomy: surgical technique and initial experience. Academic Article uri icon

Overview

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.

publication date

  • February 16, 2010

Research

keywords

  • Lymph Node Excision
  • Prostatectomy
  • Robotics

Identity

Scopus Document Identifier

  • 77951666897

Digital Object Identifier (DOI)

  • 10.1016/j.urology.2009.06.103

PubMed ID

  • 20163838

Additional Document Info

volume

  • 75

issue

  • 5