[Laparoscopic lymphadenectomy in prostate carcinoma. Experiences with 120 patients]

Laparoscopic pelvic lymph node dissection was performed in 120 patients scheduled to undergo either radical perineal prostatectomy or radiation therapy. On average 13 lymph nodes were resected in each patient, and 21 patients were found to have metastatic disease in 1-9 lymph nodes. After an initial learning curve, mean operative time was reduced significantly, allowing laparoscopic lymph node dissection and radical prostatectomy to be performed as a one-stage procedure. The overall complication rate was 10%; open revisions were necessary in only 2 of 120 patients. Postoperative hospital stay was 2 days in patients undergoing laparoscopic lymph node dissection only. This minimally invasive procedure is particularly beneficial to patients with lymph node metastases not undergoing radical prostatectomy, as well as to patients planned to be treated by radiation therapy. The combination of laparoscopic lymph node dissection and radical perineal prostatectomy avoids an abdominal incision and thus shortens both the hospital stay and the period of convalescence.