Pelvic Lymphadenectomy During Robot-assisted Radical Prostatectomy: Assessing Nodal Yield, Perioperative Outcomes, and Complications

Zorn, Kevin C.; Katz, Mark H.; Bernstein, Anya; Shikanov, Sergey; Brendler, Charles B.; Zagaja, Gregory P.; Shalhav, Arieh L.

doi:10.1016/j.urology.2009.01.077

Cited by 100 publications

(80 citation statements)

References 29 publications

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“…Similar rates of symptomatic lymphoceles are reported for open extraperitoneal prostatectomy with PLND [6,17] and endoscopic extraperitoneal radical prostatectomy [18]. Reports on symptomatic lymphocele formation after transperitoneal prostatectomies (laparoscopic or RALP) showed lower symptomatic lymphocele rates [6,19]. This observation may be explained by an unimpaired expansibility and drainage of lymphatic fluid to the abdominal cavity and subsequent peritoneal reabsorption.…”

Section: Discussionmentioning

confidence: 53%

Influence of Body Mass Index, Surgical Approach and Lymphadenectomy on the Development of Symptomatic Lymphoceles after Radical Prostatectomy

et al. 2013

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Purpose: Identification of factors influencing lymphocele formation requiring intervention after radical prostatectomy. Methods: 302 patients undergoing radical retropubic prostatectomy (RRP, n = 174) or transperitoneal robot-assisted laparoscopic prostatectomy (RALP, n = 128) by the same surgeon were retrospectively reviewed. Incidence of symptomatic lymphoceles (SLC) was compared with clinical and pathological data (contingency analyses, Wilcoxon-Kruskal-Wallis test). Results: Sixteen patients (5.3%) developed SLC. SLC occurred significantly more frequently after RRP compared to RALP (8.0 vs. 0.8%, p = 0.0008). Patients with SLC had more lymph nodes (LN) removed median (17 vs. 13, p = 0.009) and a significantly lower BMI (median 24.4 vs. 26.4, p = 0.0008). Presence of LN metastases (n = 18 patients, 6.0%) showed no statistical impact on SLC. In a multivariate analysis surgical method, the number of resected LN and the BMI remained independent predictors of SLC formation. Conclusions: The lower incidence of SLC after RALP compared to RRP probably results from peritoneal drainage of lymphatic fluid. The correlation of removed LN and SLC might be explained by increased injury of lymphatic vessels during more extended LN dissection. Why patients with lower BMI are more prone to develop SLC still remains unclear. However, early postoperative mobilization in nonobese patients might be a contributing factor.

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Section: Discussionmentioning

confidence: 53%

Influence of Body Mass Index, Surgical Approach and Lymphadenectomy on the Development of Symptomatic Lymphoceles after Radical Prostatectomy

et al. 2013

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“…The investigators removed a mean number of 12.5 lymph nodes. The perioperative parameters and complications were comparable between the two groups [27]. We have performed lymphadenectomy, when clinically indicated.…”

Section: Discussionmentioning

confidence: 89%

Oncologic results, functional outcomes, and complication rates of robotic-assisted radical prostatectomy: multicenter experience in Turkey including 1,499 patients

et al. 2014

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“…Fortunately, these events are rare in association with PLND, though they likely represent a significant cause of operative and perioperative mortality [14]. Several large series have noted the influence of PLND on thromboembolic complications, noting rates between 0.2% and 8% [20,25]. Not surprisingly, the presence of lymphocele is significantly associated with development of thromboembolic complications.…”

Section: Thromboembolic Complicationsmentioning

confidence: 99%

Complications of Pelvic Lymph Node Dissection for Prostate Cancer

Keegan

Cookson

2011

Curr Urol Rep

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Pelvic lymph node dissection (PLND) represents the standard for detection of occult pelvic nodal metastases from prostate cancer, and may be performed separately from or at the time of radical prostatectomy. In addition to its potential for diagnostic staging, a PLND may be therapeutic in some patients. However, considerable debate centers on the appropriate candidates for the procedure, the extent and proper boundaries of dissection, optimal surgical approach, and absolute oncologic benefit. Several series suggest that there likely is limited benefit of PLND in low-risk patients and that PLND can be safely omitted in a high percentage of men undergoing contemporary radical prostatectomy. Furthermore, the value of PLND in patients with intermediate- and high-risk disease must be balanced against the potential morbidity of the procedure. In the setting of this debate, concern over morbidity directly attributable to this procedure is of paramount importance. This review focuses on the complications associated with PLND, including lymphocele, thromboembolic events, ureteral injury, nerve injury, vascular injury, and lymphedema.

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Pelvic Lymphadenectomy During Robot-assisted Radical Prostatectomy: Assessing Nodal Yield, Perioperative Outcomes, and Complications

Cited by 100 publications

References 29 publications

Influence of Body Mass Index, Surgical Approach and Lymphadenectomy on the Development of Symptomatic Lymphoceles after Radical Prostatectomy

Influence of Body Mass Index, Surgical Approach and Lymphadenectomy on the Development of Symptomatic Lymphoceles after Radical Prostatectomy

Oncologic results, functional outcomes, and complication rates of robotic-assisted radical prostatectomy: multicenter experience in Turkey including 1,499 patients

Complications of Pelvic Lymph Node Dissection for Prostate Cancer

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