Laparoscopic extended pelvic lymphadenectomy for staging can be performed with limited morbidity and short hospital stay in patients with prostate cancer

Kjölhede, Henrik; Sundqvist, Pernilla

doi:10.3109/00365599.2012.681062

Cited by 4 publications

(12 citation statements)

References 19 publications

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“…One study reported standardized complications after laparoscopic staging PLND. 12 In 133 high-risk PCa patients, Liedberg et al reported 26% grade 1, 8% grade 2 and 2% grade 3 complications, which is in line with the present results (10%, 3% and 6% respectively). The fact that both our studies showed no grade 4-5 complications underlines the safety of this MI surgery.…”

Section: Discussionsupporting

confidence: 92%

“…The fact that both our studies showed no grade 4-5 complications underlines the safety of this MI surgery. 12 Additionally, we compared MI-with O-PLND (n = 43). With MI-PLND we saw fewer postoperative grade 3 complications (6% vs 16% with O-PLND), although this numerical difference was not statistically significant (P = 0.100).…”

Section: Discussionmentioning

confidence: 99%

“…With MI-PLND, 95 patients (95%) underwent extended and five patients (5%) underwent limited PLND: two obturator + hypogastric and three obturator-only. Operation time (skin-to-skin) was longer with MI-PLND (130 [70-240] vs 98 [59-200] min; P < 0.001), but there was less blood loss with MI-PLND (drop in hemoglobin on postoperative day 1: 1.1 ± 0.91 vs 1.7 ± 0.76 g/dL; P = 0.001) and hospital stay was shorter (3 [2][3][4][5][6][7][8][9][10][11][12][13][14] vs 6 [3-10] days; P < 0.001).…”

Section: Surgical Detailsmentioning

confidence: 99%

“…Contemporary PLND complication rates vary between 2-38%, with development of a symptomatic lymphocele being the main complication (0-11%). [8][9][10][11][12] Overall, (asymptomatic) lymphoceles have been reported in 18-61% of patients. [13][14][15] To our knowledge, only one study prospectively assessed the complication rate after laparoscopic staging PLND using a standardized classification.…”

Section: Introductionmentioning

confidence: 99%

“…[13][14][15] To our knowledge, only one study prospectively assessed the complication rate after laparoscopic staging PLND using a standardized classification. 12 The goal of the present study was to assess complications of staging MI-PLND by reporting on surgical outcome and compare this with O-PLND. Additionally, we analyzed overall and symptomatic lymphocele formation rate.…”

Section: Introductionmentioning

confidence: 99%

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Contemporary minimally‐invasive extended pelvic lymph node dissection for prostate cancer before curative radiotherapy: Prospective standardized analysis of complications

et al. 2014

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Abbreviations & AcronymsObjectives: To prospectively assess contemporary complication rates of minimallyinvasive staging pelvic lymph node dissection before curative radiotherapy for prostate cancer using a standardized classification. Methods: A total of 100 prostate cancer patients underwent laparoscopic or robotassisted pelvic lymph node dissection (95% extended). Surgical outcomes were compared with those of 43 patients undergoing open pelvic lymph node dissection (33% extended).Complications were recorded prospectively during hospitalization and follow-up visits, and graded using Clavien-Dindo classification. Lymphocele size was measured on postoperative magnetic resonance imaging or computed tomography. Results: Of the complications recorded, 10% were grade 1, 3% were grade 2 and 6% were grade 3. No grade 4-5 complications occurred. Compared with open pelvic lymph node dissection, minimally-invasive pelvic lymph node dissection was associated with less blood loss (P = 0.001) and shorter hospital stay (median 3 vs 6 days; P < 0.001), but longer operation time (130 vs 98 min; P < 0.001). The complication rate was similar in both groups. For the entire cohort, overall and symptomatic lymphoceles were seen in 91 (64%) and 18 patients (13%), respectively. On multivariate logistic regression, minimally-invasive surgery was the only independent predictor for lymphocele development (odds ratio 3.99; P = 0.015). Conclusions: Minimally-invasive extended pelvic lymph node dissection before curative radiotherapy is associated with low morbidity. Asymptomatic lymphocele development rate is higher compared with open pelvic lymph node dissection.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%