The value of laparoscopic lymphadenectomy in conjunction with radical perineal or retropubic prostatectomy

A total of 76 men with clinically localized prostate cancer underwent surgical treatment at our institution during an 11-month period. Of the patients 26 underwent staging laparoscopic pelvic lymph node dissection followed by radical perineal prostatectomy (group 1), 24 underwent laparoscopic pelvic lymph node dissection and radical retropubic prostatectomy (group 2), and 26 underwent standard open lymphadenectomy and radical retropubic prostatectomy (group 3). Group 1 patients experienced statistically significantly less average blood loss (576 +/- 360 cc) than either group 2 (1,275 +/- 686.8) or 3 (1,100 +/- 459, p < 0.001). Hospital stay was also significantly less in group 1, with a mean of 4.6 +/- 1.9 days compared to 9.6 +/- 4.6 and 7.25 +/- 2.06 days for groups 2 and 3, respectively (p < 0.001). Our study supports the combination of laparoscopic pelvic lymph node dissection and radical perineal prostatectomy as a potentially less morbid approach to the surgical treatment of prostate cancer. However, no benefit was found for laparoscopic staging in patients before radical retropubic prostatectomy.