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Hip and knee replacement as a relative contraindication to laparoscopic pelvic lymph node dissection
C S Cooper1, J F Donovan, R B Terrell
1Department of Urology, University of Iowa, Iowa City, USA.
The Journal of Urology
|July 1, 1997
Summary
Lower extremity joint prostheses may complicate laparoscopic pelvic lymph node dissection. This procedure carries increased risks and may not be suitable for all patients with hip or knee replacements.
Area of Science:
- Surgical Oncology
- Orthopedic Surgery
Background:
- Laparoscopic pelvic lymph node dissection is a standard oncologic procedure.
- Total hip or knee replacement are common orthopedic surgeries.
Purpose of the Study:
- To investigate the impact of lower extremity joint prostheses on subsequent laparoscopic pelvic lymph node dissection outcomes.
Main Methods:
- Retrospective review of 5 patients who underwent laparoscopic pelvic lymph node dissection after hip or knee replacement between 1990 and 1995.
- Analysis of surgical records and pathology findings.
Main Results:
- Four out of five procedures were complicated.
- Three dissections failed to obtain bilateral pelvic lymph nodes.
- Two cases required conversion to open surgery.
- Sinus histiocytosis was observed in 4 cases with removed nodal tissue.
Conclusions:
- Lower extremity joint prostheses may increase the risk of complications during laparoscopic pelvic lymph node dissection.
- The presence of such prostheses might be a contraindication for this minimally invasive approach.