Staging laparoscopic pelvic lymph node dissection: comparison of results with open pelvic lymphadenectomy

A total of 24 men scheduled for radical prostatectomy was alternately designated to undergo either a modified open (12 men) or laparoscopic (12 men) lymphadenectomy. Both groups were similar in regard to age and clinical stage. Tumor grade and serum prostate specific antigen level for each group are reported. Nodal metastases were found in 1 patient in the open and 3 in the endoscopic group. The average total number of lymph nodes retrieved by open dissection was 11 +/- 5.7, which was not statistically different from the average number of 10.7 +/- 5.7 obtained laparoscopically. No statistically significant variance in the number of nodes harvested in regard to site of dissection was observed. In the 9 men who underwent radical prostatectomy after laparoscopic dissection no additional lymphatic tissue was obtained from the surgical margins. No morbidity related to either procedure occurred. The data suggest that laparoscopic pelvic lymphadenectomy offers a reliable and minimally invasive alternative to open node dissection in selected patients.