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[Laparoscopic pelvic lymph node dissection valuable in the staging of clinically localized prostate carcinoma]
F M Froeling1, J A Witjes, G O Oosterhof
1Academisch Ziekenhuis, afd. Urologie, Nijmegen.
Objective:
To assess the value of laparoscopic lymph node dissection of the obturator fossa in patients with prostate carcinoma with high risk of lymph node metastases.
Design:
Prospective descriptive study.
Setting:
Department of Urology, University Hospital Nijmegen, the Netherlands.
Method:
Prior to curative therapy for prostate carcinoma a bilateral laparoscopic pelvic lymph node dissection was performed in 25 patients, with a high risk of lymph node metastases on the basis of tumour size, tumour grade or serum prostate specific antigen.
Results:
In 52% (13/25) of the patients lymph node metastases were found. Once a laparotomy was performed for an arterial bleeding. A mean of 11.6 lymph nodes were removed during bilateral dissection of the obturator fossa. Three quarter of the patients were discharged one day postoperatively.
Conclusion:
A laparoscopic lymph node dissection is a valuable tool for the evaluation of pelvic lymph nodes in patients with a clinically localised prostate carcinoma and a high risk of lymph node metastases.