title: Robot-Assisted Extended Pelvic Lymph Nodes Dissection for Prostate Cancer: Personal Surgical Technique and Outcomes.
abstract: OBJECTIVE
  Extended pelvic lymph nodes dissection (EPLND) allows the removal of a higher number of lymph nodes than limited PLND. The aims of this study were to describe our robot-assisted EPLND (RAEPLND) technique with related complications, and to report the number of lymph nodes removed and the rate of lymph nodal metastasis.
  
  
  METHODS
  153 patients underwent RAEPLND prior to robot-assisted radical prostatectomy (RARP). Indications were defined according to Briganti nomogram, to predict risk of lymph-nodal metastasis. Lymphatic packages covering the distal tract of the common iliac artery, the medial portion of the external iliac artery, the external iliac vein and the internal iliac vessels, together with the obturator and the presacral lymphatic packages were removed on both sides.
  
  
  RESULTS
  Median preoperative PSA was 7.5 ng/mL (IQR 5.5-11.5). Median operative time was 150 min (135-170). Median RAEPLND alone operative time was 38 min (32.75-41.25); for right and left side, 18 (15-29) and 20 min (15.75-30) (p=0.567). Median number of lymph nodes retrieved per patient was 25 (19.25-30); 13 (11-16) and 11 (8-15) for right and left side. In 19 patients (12.41%) metastasis was found at the level of pelvic lymph nodes. Median number of positive lymph nodes was 1 (1-4.6) per patient. Complications occurred in 11 patients (7.3%).
  
  
  CONCLUSIONS
  the number of lymph nodes removed was comparable to published data about open series, allowing the increase of detection rate of lymph nodal metastasis for minimally invasive approach without compromising complications' rate if performing the procedure following reported technique.
authors.affiliation: Divisione di Urologia, Dipartimento di Oncologia, Universita di Torino, San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano (Torino), Italia.
authors.forename: Francesco
authors.initials: F
authors.lastname: Porpiglia
authors.affiliation: Divisione di Urologia, Dipartimento di Oncologia, Universita di Torino, San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano (Torino), Italia.
authors.forename: Stefano
authors.initials: S
authors.lastname: De Luca
authors.affiliation: Divisione di Urologia, Dipartimento di Oncologia, Universita di Torino, San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano (Torino), Italia.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bertolo
authors.affiliation: Divisione di Medicina Nucleare, Dipartimento di Internal Medicina, Universita di Torino, Ospedale San Giovanni Battista, Corso AM Dogliotti 14, 10126 Torino, Italia.
authors.forename: Roberto
authors.initials: R
authors.lastname: Passera
authors.affiliation: Divisione di Urologia, Dipartimento di Oncologia, Universita di Torino, San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano (Torino), Italia.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Mele
authors.affiliation: Divisione di Urologia, Dipartimento di Oncologia, Universita di Torino, San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano (Torino), Italia.
authors.forename: Matteo
authors.initials: M
authors.lastname: Manfredi
authors.affiliation: Divisione di Urologia, Dipartimento di Oncologia, Universita di Torino, San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano (Torino), Italia.
authors.forename: Daniele
authors.initials: D
authors.lastname: Amparore
authors.affiliation: Divisione di Urologia, Dipartimento di Oncologia, Universita di Torino, San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano (Torino), Italia.
authors.forename: Ivano
authors.initials: I
authors.lastname: Morra
authors.affiliation: Divisione di Urologia, Dipartimento di Oncologia, Universita di Torino, San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano (Torino), Italia.
authors.forename: Cristian
authors.initials: C
authors.lastname: Fiori
mesh_terms: D000368:Aged; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D061646:Operative Time; D010388:Pelvis; D011183:Postoperative Complications; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*
chemical_list: D017430:Prostate-Specific Antigen