LAPAROSCOPIC PELVIC LYMPH-NODE DISSECTION - A REVIEW OF 103 CONSECUTIVE CASES

Laparoscopic pelvic lymph node dissection is a recently introduced tec hnique for the surgical evaluation of the regional pelvic lymph nodes in genitourinary malignancies. We report the results of a laparoscopic pelvic lymph node dissection performed on 103 consecutive patients fo r staging of clinically localized prostatic, bladder and penile carcin omas. In 20 patients (group 1) the adequacy of the laparoscopic pelvic lymph node dissection was evaluated with a subsequent open dissection . In this group 87 to 95% of the lymph nodes within a modified templat e could be reliably removed laparoscopically. In 73 patients (group 2) laparoscopic pelvic lymph node dissection was performed as a solitary operation. Mean hospitalization was 1.6 +/- 2.4 days, while postopera tive narcotic requirements were minimal. Mean operative time for bilat eral laparoscopic pelvic lymph node dissection was 156 +/- 41.2 minute s. The overall complication rate in these 2 groups was 13.5%. Group 3 includes 10 patients (9.7% of the total) in whom laparoscopic pelvic l ymph node dissection was unsuccessful. The minimally invasive surgical techniques of laparoscopic pelvic lymph node dissection seem to provi de adequate staging accuracy in patients with genitourinary neoplasms. The complication rate and recovery period appear to be decreased rela tive to those for open surgical lymphadenectomy.