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[Preliminary data on our laparoscopy experience in urinary pathology]
P Geavlete1, C Dragomirescu, M Liţescu
1Clinica de Chirurgie Urologică, Spital Clinic Sfântul Loan, Bucureşti.
Abstract:
We studied laparoscopic urological procedures in 14 cases between July 1995 and October 1996. We applied retroperitoneal lomboscopic technique for 2 cases with symptomatic renal cyst (over 500 ml) and laparoscopic retroperitoneal lymphadenectomy in 12 cases (adenocarcinoma of the prostate-5 cases, pT2-3bMo, Gleason score between 3-9, PSA between 11-46 ng/ml and invasive bladder tumors-7 cases, pT2-3bMoG2-3). For the renal cyst we used extraperitoneal approach and for the pelvic lymph nodes we used in 8 cases intraperitoneal approach and in 4 cases extraperitoneal approach (patients with multiple prior abdominal surgeries). Lymph node tissue was present in 11 cases. For the bladder tumors we did first iliac lymph nodes dissection and for the prostate adenocarcinoma we did first obturator lymph nodes dissection. We didn't describe complications. For our patients it was 3 days long hospitalization. So, we consider that laparoscopic lymphadenectomy is essential for evaluation of the patients with prostate adenocarcinoma having markedly elevated prostate specific antigen, high Gleason grade, large clinical burden of tumor. For the invasive bladder tumors, radical cystectomy and especially bladder replacement surgery need absolutely evaluation of regional lymph nodes. For the symptomatic renal cysts (over 500 ml) laparoscopic surgery is with very good results, minimally invasive.