Laparoscopic standard pelvic node dissection for carcinoma of the prostate: is it accurate?

The acceptably low morbidity of laparoscopic pelvic lymphadenectomy has allowed us to perform the procedure systematically on all patients who presented with localized adenocarcinoma of the prostate. Data on 147 consecutive cases enable us to state that the overall accuracy and morbidity of this method are equal if not better than the rates available in the literature for open procedures. In addition, analysis shows that the standard dissection is more accurate than the obturator dissection because in 30% of the patients with positive nodes malignant infiltrates were found in the iliac specimen only. Finally, it appears that patients in whom the malignancy was detected by ultrasound only may not require lymphadenectomy because in our group of 28 patients no positive nodes were detected.