PROSTATE-CANCER STAGING AFTER RADIATION UTILIZING LAPAROSCOPIC PELVICLYMPHADENECTOMY

Objectives. This report assesses the feasibility of laparoscopic pelvi c lymphadenectomy in irradiated patients with prostate cancer being co nsidered for salvage therapy. Methods. Six men, each with a prior hist ory of external beam radiation therapy, and prostate-specific antigen or clinical failure, were selected as potential candidates for salvage therapy. Utilizing a standard diamond pattern trocar conformation, la paroscopy was performed to evaluate pelvic lymph node status. Results. The procedure was successfully completed in all patients with a mean operating room time of 154 minutes. Blood loss averaged 55 cc. Serious intraoperative or postoperative complications were not encountered in the follow-up of 6 months. Metastatic disease was demonstrated in 1 p atient. Conclusions. Laparoscopic pelvic lymph node dissection is tech nically feasible in patients who have received irradiation, and appear s to confer no additional morbidity over standard laparoscopic lymphad enectomy.