Gasman D, Barthélémy Y, Antiphon P, Chopin D, Abbou C
Service d'Urologie, Hôpital Henri Mondor, Créteil.
Prog Urol. 1994 Aug-Sep;4(4):516-21; discussion 521-2.
Laparoscopic lymphadenectomy was performed among 15 patients. The average age was 65.5 years. The group was made of 13 T2 and 2 T3. The average time of procedure was 175 min (90 à 240 min). The average number of lymph nodes removed laparoscopically from these patients was 5.3 on the left and 6.4 on the right. Metastatic nodes were found in 5 cases (33%) and among all these 5 patients the PSA level was above 30 and/or the Gleason score > 6. We noticed 3 major complications (2 bowel and 1 vascular injuries). Radical prostatectomy was made in 8 patients and nevertheless this intervention did not become more difficult. As a conclusion, this is a procedure which allows a good node staging but the complication rate is still high and will decrease with experience. The merits of such a method are still to be evaluated in localized prostatic cancer.
对15例患者实施了腹腔镜淋巴结清扫术。平均年龄为65.5岁。该组由13例T2期和2例T3期患者组成。手术平均时间为175分钟(90至240分钟)。这些患者经腹腔镜切除的淋巴结平均数量,左侧为5.3个,右侧为6.4个。5例(33%)发现有转移淋巴结,在这5例患者中,前列腺特异抗原(PSA)水平均高于30,和/或 Gleason评分>6。我们注意到3例严重并发症(2例肠道损伤和1例血管损伤)。8例患者接受了根治性前列腺切除术,不过该手术并未变得更加困难。总之,该手术能实现良好的淋巴结分期,但并发症发生率仍然较高,且会随着经验的积累而降低。这种方法在局限性前列腺癌中的优势仍有待评估。