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Pelvic Lymph Node Dissection by Robotic Prostatectomy
Mon - May 9, 2011 10:03 am  |  Article Hits:4347  |  A+ | a-
Although PELVIC LYMPH NODE DISSECTION during radical prostatectomy can offer important staging information, it's also associated with complications for example lymphocele formation and problems for adjacent structures.One in this issue from the Journal Eifler et al (page 1661) from Baltimore, Maryland present their experience performing PELVIC LYMPH NODE DISSECTION during laparoscopic radical prostatectomy and subsequent symptomatic venous thromboembolism (VTE). They examined the records of nearly 800 men who underwent surgery with a single surgeon. Limited or standard PELVIC LYMPH NODE DISSECTION was performed in approximately 60% in men at increased risk for lymph node metastasis.

Even though overall incidence of symptomatic VTE was less than 1%, a substantial association was noted between VTE and PELVIC LYMPH NODE DISSECTION, in conjuction with the meta-analysis of the literature on this topic. Based on available nomograms, the probability of lymph node involvement with prostate cancer could be reliably assessed before surgery. Regardless of surgical approach, an experienced surgeon can perform PELVIC LYMPH NODE DISSECTION with comparable lymph node yields. However, having a downward stage migration of cancer of the prostate, the role of extended PELVIC LYMPH NODE DISSECTION during radical prostatectomy has been questioned, especially in low risk patients. Therefore, the role and potential benefits of PELVIC LYMPH NODE DISSECTION during radical prostatectomy ought to be carefully weighed against its rare yet significant complications.

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