Complications of laparoscopic pelvic lymph node dissection.
Intraoperative and postoperative complications were assessed in the first 372 patients undergoing laparoscopic pelvic lymph node dissection at 8 medical centers. In 16 patients laparoscopic node dissection could not be completed due to patient body habitus or technical difficulties. Of these aborted procedures 14 occurred during the initial 8 dissections at each institution. A total of 55 complications (15%) occurred: 14 were noted in the intraoperative and 41 in the postoperative period. Of these patients 13 required open surgical intervention for the treatment of a complication. Complications included vascular injury (11 patients), viscus injury (8), genitourinary problems (10), functional/mechanical bowel obstruction (7), lower extremity deep venous thrombosis (5), infection/wound problem (5), lymphedema (5), anesthetic complications (2) and obturator nerve palsy (2). Based on our experience, there is a significant learning curve associated with performing laparoscopic pelvic node dissection. However, with experience and adherence to laparoscopic surgical principles, the risk of complications may be minimized.
Kavoussi
L R
LR
Department of Urology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115.
Sosa
E
E
Chandhoke
P
P
Chodak
G
G
Clayman
R V
RV
Hadley
H R
HR
Loughlin
K R
KR
Ruckle
H C
HC
Rukstalis
D
D
Schuessler
W
W
D000230:Adenocarcinoma / Q000556:secondary / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D010388:Pelvis; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies