Laparoscopic Pelvic Lymph Node Dissection in Patients with Prostate Cancer: the Early Experience

So, Young Seog; Kim, Chul Sung

Abstract

PURPOSE: The status of the pelvic lymph node provides important information with respect to the choice of therapy and prognosis in patients with prostate cancer. we evaluated the clinical effectiveness and safety of laparoscopic pelvic lymph node dissection in 7 patients with prostate cancer.
MATERIALS AND METHODS
From July 1996 to December 1997, 7 patients whose mean age was 67.7year (range 56-73) underwent transperitoneal laparoscopic pelvic lymph node dissection as a staging procedure for prostatic cancer. We evaluated the clinical stage, Gleason score, PSA, number of harvested lymph nodes, operative time, postoperative hospital stay, and complications.
RESULTS
Clinical stage was T1c-T2c, and mean Gleason score was 7.6(range 6-10). Mean preoperative PSA was 35.3ng/ml(range 19-56.2). The mean number of removed lymph nodes was 8.4(range 5-12) and lymph node metastases were noted in 2 patients. Mean operative time was 180.7minutes (range 140-260). Mean postoperative hospital stay was 2.1 days(range 2-3). Conversion from the laparoscopic procedure to open surgery was not required. Subcutaneous emphysema occurred in 2 patients and was conservatively managed.
CONCLUSIONS
Our preliminary experience suggests that laparoscopic pelvic lymph node dissection could be performed safely and efficiently to detect the pelvic lymph node metastasis in patients with prostate cancer with a short hospital stay and a low morbidity, though being more time-consuming.