title: Lymph node dissection during laparoscopic (LRC) and open (ORC) radical cystectomy due to muscle invasive bladder urothelial cancer (pT2-3, TCC).
abstract: OBJECTIVE
  The aim of the study was to compare the number of nodes dissected during laparoscopic and open radical cystoprostatectomy in men or anterior exenteration in women due to muscle invasive bladder urothelial cancer (IBC).
  
  
  METHODS
  Fifty-one patients treated with laparoscopic radical cystectomy (LRC) and 63 with open radical cystectomy (ORC) were compared. The LRC group consisted of 47 pT2 tumours and 4 pT3, while the ORC group was composed of 27 pT2 tumours and 36 pT3. During ORC external, internal, common iliac and obturator lymph nodes were removed separately, but were added and analysed together for each side. Nodes dissected from one side during ORC were compared to en bloc dissected nodes in the LRC group.
  
  
  RESULTS
  There were no complications associated with extended pelvic lymph node dissection during LRC or ORC. There were significant differences in the mean number of resected lymph nodes between LRC and ORC for pT2 tumours. The laparoscopic approach allowed about 8-9 more lymph nodes to be removed than open surgery in the pT2 group. In 15% of patients with pT2 disease treated with open radical cystectomy node metastases were observed. Active disease was detected in 18% of nodes resected laparoscopically due to pT2 disease. Fourty-seven percentage of patients with pT3 disease treated with open surgery were diagnosed as harbouring metastatic lymph nodes. The laparoscopic group with pT3 disease was too small to analyse.
  
  
  CONCLUSIONS
  We have found that laparoscopic radical cystectomy can be performed without any compromise in lymph node dissection. The technique of lymph node dissection (LND) during laparoscopic cystectomy (LRC) resulted in sufficient resected lymphatic tissue, especially in patients with bladder-confined tumours with a low volume of lymph nodes.
authors.affiliation: Department of Urology, Institute of Oncology, Kielce, Poland ; University of Humanities and Sciences, Faculty of Health, Kielce, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Chlosta
authors.forename: Tomasz
authors.initials: T
authors.lastname: Drewa
authors.forename: Jerzy
authors.initials: J
authors.lastname: Siekiera
authors.forename: Jarosław
authors.initials: J
authors.lastname: Jaskulski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Petrus
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kamecki
authors.forename: Witold
authors.initials: W
authors.lastname: Mikołajczak
authors.forename: Mateusz
authors.initials: M
authors.lastname: Obarzanowski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Wronczewski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Krasnicki
authors.forename: Milosz
authors.initials: M
authors.lastname: Jasinski