title: Complications of laparoscopic pelvic lymph node dissection.
abstract: 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.
authors.affiliation: Department of Urology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115.
authors.forename: L R
authors.initials: LR
authors.lastname: Kavoussi
authors.forename: E
authors.initials: E
authors.lastname: Sosa
authors.forename: P
authors.initials: P
authors.lastname: Chandhoke
authors.forename: G
authors.initials: G
authors.lastname: Chodak
authors.forename: R V
authors.initials: RV
authors.lastname: Clayman
authors.forename: H R
authors.initials: HR
authors.lastname: Hadley
authors.forename: K R
authors.initials: KR
authors.lastname: Loughlin
authors.forename: H C
authors.initials: HC
authors.lastname: Ruckle
authors.forename: D
authors.initials: D
authors.lastname: Rukstalis
authors.forename: W
authors.initials: W
authors.lastname: Schuessler
mesh_terms: 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