Lymph node dissection during laparoscopic (LRC) and open (ORC) radical cystectomy due to muscle invasive bladder urothelial cancer (pT2-3, TCC)
| Autor: | Piotr Chlosta, Witold Mikołajczak, Mateusz Obarzanowski, Jarosław Jaskulski, Andrzej Wronczewski, Milosz Jasinski, Jerzy Siekiera, Krzysztof Kamecki, Tomasz Drewa, Andrzej Petrus, Krzysztof Krasnicki |
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| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
Urology medicine.medical_treatment Obturator Lymph Node lcsh:Medicine lymph node dissection urologic and male genital diseases Cystectomy laparoscopic radical cystectomy medicine Urothelial cancer open radical cystectomy Lymph node Original Paper business.industry Prostatectomy lcsh:R Gastroenterology Muscle invasive Obstetrics and Gynecology Surgery Dissection medicine.anatomical_structure Lymph business |
| Zdroj: | Videosurgery and other Miniinvasive Techniques Videosurgery and Other Miniinvasive Techniques, Vol 6, Iss 3, Pp 127-131 (2011) |
| ISSN: | 2299-0054 1895-4588 |
| Popis: | Aim: The aim of the study was to compare the number of nodes dissected during laparoscopic and open radical cysto- prostatectomy in men or anterior exenteration in women due to muscle invasive bladder urothelial cancer (IBC). Material and methods: Fifty-one patients treated with laparoscopic radical cystectomy (LRC) and 63 with open radi- cal cystectomy (ORC) were compared. The LRC group consisted of 47 pT2 tumours and 4 pT3, while the ORC group was composed of 27 pT2 tumours and 36 pT3. During ORC external, internal, common iliac and obturator lymph nodes were removed separately, but were added and analysed together for each side. Nodes dissected from one side during ORC were compared to en bloc dissected nodes in the LRC group. Results: There were no complications associated with extended pelvic lymph node dissection during LRC or ORC. There were significant differences in the mean number of resected lymph nodes between LRC and ORC for pT2 tumours. The laparoscopic approach allowed about 8-9 more lymph nodes to be removed than open surgery in the pT2 group. In 15% of patients with pT2 disease treated with open radical cystectomy node metastases were observed. Active disease was detected in 18% of nodes resected laparoscopically due to pT2 disease. Fourty-seven percentage of patients with pT3 disease treated with open surgery were diagnosed as harbouring metastatic lymph nodes. The laparoscopic group with pT3 disease was too small to analyse. Conclusions: We have found that laparoscopic radical cystectomy can be performed without any compromise in lymph node dissection. The technique of lymph node dissection (LND) during laparoscopic cystectomy (LRC) resulted in sufficient resected lymphatic tissue, especially in patients with bladder-confined tumours with a low volume of lymph nodes. |
| Databáze: | OpenAIRE |
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