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Postchemotherapy laparoscopic retroperitoneal lymph node dissection: evaluation of complications
Sompol Permpongkosol1, Guilherme C Lima, Christopher A Warlick
1James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Urology
|February 27, 2007
Summary
Laparoscopic retroperitoneal lymph node dissection (LRPLND) after chemotherapy is feasible. Increased surgeon experience significantly reduces complication rates and improves patient outcomes.
Area of Science:
- Urology
- Surgical Oncology
Background:
- Laparoscopic retroperitoneal lymph node dissection (LRPLND) for post-chemotherapy patients has been associated with significant morbidity.
- Further evaluation of complication rates with accumulated experience is warranted.
Purpose of the Study:
- To review the complication rate of post-chemotherapy laparoscopic retroperitoneal lymph node dissection (LRPLND) with additional surgical experience.
- To assess the feasibility and safety of LRPLND in this patient population.
Main Methods:
- Retrospective review of 16 consecutive patients undergoing post-chemotherapy LRPLND by a single surgeon (1996-2005).
- Evaluation included tumor type, clinical and pathologic stage, and intraoperative/postoperative complications.
Main Results:
- Successful LRPLND in 87.5% of patients; 43.8% experienced complications, mostly minor and postoperative.
- Vascular complications occurred only in the early part of the series (1996-2000).
- Median hospital stay was 2 days; no deaths occurred. No retroperitoneal recurrence observed during follow-up.
Conclusions:
- Post-chemotherapy LRPLND is a challenging yet feasible procedure.
- Accumulated surgical experience can significantly decrease complication incidence and overall morbidity.
- LRPLND offers a potentially safe and effective treatment option for select patients.