Extended lymph node dissection in robot-assisted radical prostatectomy： lymph node yield and distribution of metastases

作     者：Kwang Hyun Kim Sey Kiat Lim Kyo Chul Koo Woong Kyu Han Sung Joon Hong Koon Ho Rha 

作者机构：Department of Urology Urological Science Institute Yonsei University College of Medicine Seoul Korea Department of Urology Ewha Womans University School ot Medicine Seoul Korea. 

出 版 物：《Asian Journal of Andrology》 (亚洲男性学杂志（英文版）)

年 卷 期：2014年第16卷第6期

页      面：824-828页

核心收录：

学科分类：090602[农学-预防兽医学] 1002[医学-临床医学] 080202[工学-机械电子工程] 08[工学] 09[农学] 0906[农学-兽医学] 0804[工学-仪器科学与技术] 0802[工学-机械工程] 

基　　金：supported by the Research Foundation of Korea (NRF) grant funded by the Korean government (MEST) 

主　　题：lymph node excision prostatectomy prostatic neoplasm robotics 

摘      要：In this study, we reported our experience performing robotic extended lymph node dissection （eLND） in patients with prostate cancer. A total of 147 patients with intermediate and high-risk prostate cancer who underwent robotic eLND from May 2008 to December 2011 were included in this analysis. The dissection template extended to the ureter crossing the iliac vessels. We assessed lymph node yield, lymph node positivity, and perioperative outcomes. Lymph node positivity was also evaluated according to the number of lymph nodes （LNs） removed （〈22 vs 〉22）. The median number of LNs removed was 22 （11-51）, and 97 positive LNs were found in 24 patients （16.3%）. While the obturator fossa was the most common site for LN metastases （42.3%, 41/97）, the internal iliac area was the most common area for a single positive LN packet （20.8%, 5/24）. Eight patients （33.3%, 8/24） had positive LNs at the common iliac area. The incidence of positive LNs did not differ according to the number of LNs removed. Complications associated with eLND occurred in 21 patients （14.3%） and symptomatic lymphocele was found in five patients （3.4%）. In conclusion, robotic eLND can be performed with minimal morbidity. Furthermore, LN yield and the node positive rate achieved using this robotic technique are comparable to those of open series. In addition, the extent of dissection is more important than the absolute number of LNs removed in eLND, and the robotic technique is not a prohibitive factor for performing eLND.