Outpatient pelvic lymph node dissection.
OBJECTIVE
Staging pelvic lymph node dissection is an important part of the evaluation of most patients with prostatic carcinoma. While laparoscopic pelvic lymph node dissection provides an alternative to standard pelvic lymph node dissection, it has been associated with a significant learning curve, high major complication rate, frequent hospitalization and greater expense. We sought to modify the technique of pelvic lymph node dissection to allow its performance as an outpatient procedure.


METHODS
Pelvic lymph node dissection was performed through bilateral 3 cm. incisions overlying the obturator fossa in 11 patients.


RESULTS
Nodes sampled ranged from 5 to 26 per patient that differed insignificantly from those undergoing standard pelvic lymph node dissection. Four patients had lymph node metastases. Nine procedures were performed entirely on an outpatient basis. One complication (external vein injury) was repaired with a single suture after extending the incision to 6 cm.


CONCLUSIONS
Outpatient pelvic lymph node dissection through small incisions provides an attractive alternative to standard or laparoscopic lymph node dissection. With further experience it may become the procedure of choice for staging prostatic carcinoma in patients with a high risk of pelvic lymph node metastases.
Mohler
J L
JL
Department of Surgery, University of North Carolina at Chapel Hill, USA.
D000368:Aged; D000556:Ambulatory Surgical Procedures; D004867:Equipment Design; D006801:Humans; D008197:Lymph Node Excision / Q000295:instrumentation / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery