Does extended lymphadenectomy increase the morbidity of radical cystectomy?
OBJECTIVE
To report the events during and after radical cystectomy and urinary diversion for bladder cancer, in terms of major and minor complications, comparing a minimal with an extended lymphadenectomy, as more lymph nodes obtained during radical cystectomy may improve staging and thus the outcome.


METHODS
We reviewed 92 consecutive patients who underwent radical cystectomy from March 1998 to February 2002; 46 had a minimal (group A) and 46 an extended lymphadenectomy (group B). Cases were selected according to the American Society of Anesthesiologists classification, only including those graded 2 or 3. We specifically evaluated the incidence and type of complications within 30 days after surgery.


RESULTS
Because of extending the lymphadenectomy the operative duration was a median of 63 min longer in group B (P < 0.01). Complications requiring surgical interventions occurred in four (9%) patients in group A and five (11%) in group B (P = 0.28). Complications requiring no surgical intervention were also similar in both groups. Three patients died, two in group A and one in group B (P = 0.57).


CONCLUSIONS
Extended lymphadenectomy in radical cystectomy does not increase the morbidity within 30 days of surgery.
Brössner
C
C
Department of Urology, Oberwart Hospital, Oberwart, Austria. broessner@utanet.at
Pycha
A
A
Toth
A
A
Mian
C
C
Kuber
W
W
D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D007902:Length of Stay; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods* / Q000401:mortality