LAPAROSCOPIC LYMPHADENECTOMY IN THE DIAGN OSIS OF LOCALLY CONFINED CARCINOMA OF THE PROSTATE - REVIEW OF 200 OPERATIONS

In 200 patients with prostate cancer of clinical stages T1 - T3 and a mean PSA level of 44 ng/ml, we performed bilateral laparoscopic pelvic lymphadenectomy (LPLA). An average of 11 lymph nodes were removed, ly mph node metastases being detected in 44/156 patients (22%). Operating time was reduced from an initial average time of 125 minutes to 60 mi nutes. In 8 patients (4%) we observed major complications, in 15 patie nts (7.5%) minor complications. In 40/156 without lymph node metastase s we performed perineal prostatectomy, in 3/156 retropubic prostatecto my, and afterloading radiation therapy in 113/156 patients. The 44 pat ients with lymph node metastases either underwent orchiectomy under th e same anaesthesia or castration by drugs was initiated. LPLA is a use ful staging method which takes a key position in therapeutical-decisio n finding at our clinic in patients with organ-confined cancer of the prostate.