title: Extraperitoneal pelvioscopy in staging of bladder carcinoma and detection of pelvic lymph node metastasis.
abstract: This study was carried out to examine the efficacy of extraperitoneal pelvioscopy in detecting pelvic metastasis in patients scheduled to undergo radical cystectomy without preoperative chemo- or radiotherapy. The results of pelvioscopy were compared with those obtained by laparotomy. 54 consecutive patients underwent pelvioscopy without complications. Three were technically insufficient. Lymphatic tissue was biopsied in 29 (54%). Pelvioscopy demonstrated tumor dissemination in 5 patients (9.3%): 2 had pT4b tumor, 2 pelvic nodal metastases and 1 both. The remaining 49 patients with benign pelvioscopy were scheduled for laparotomy but 7 patients did not undergo the procedure: 3 had extrapelvic metastasis, 1 bronchial carcinoma, 1 aortic aneurysm, 1 refused surgery and 1 had pulmonary insufficiency. Accordingly, 42 patients underwent open exploration which demonstrated pelvic metastasis in 11: 9 had nodal metastasis, 1 a pT4b tumor and 1 both. Consequently the sensitivity of pelvioscopy in detecting pelvic metastasis was calculated at only 31%. This result indicates that extraperitoneal pelvioscopy should be considered a screening procedure rather than an accurate staging procedure for pelvic metastasis.
authors.affiliation: Department of Urology, Herlev Hospital, University of Copenhagen, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Ovesen
authors.forename: P
authors.initials: P
authors.lastname: Iversen
authors.forename: R
authors.initials: R
authors.lastname: Beier-Holgersen
authors.forename: T
authors.initials: T
authors.lastname: Hald
authors.forename: F
authors.initials: F
authors.lastname: Rasmussen
authors.forename: K
authors.initials: K
authors.lastname: Steven
mesh_terms: D000328:Adult; D000368:Aged; D015653:Cystectomy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery