Jarrard D F, Chodak G W
University of Chicago, Department of Surgery, Illinois, USA.
Urology. 1995 Oct;46(4):538-41. doi: 10.1016/S0090-4295(99)80268-4.
This report assesses the feasibility of laparoscopic pelvic lymphadenectomy in irradiated patients with prostate cancer being considered for salvage therapy.
Six men, each with a prior history of external beam radiation therapy, and prostate-specific antigen or clinical failure, were selected as potential candidates for salvage therapy. Utilizing a standard diamond pattern trocar conformation, laparoscopy was performed to evaluate pelvic lymph node status.
The procedure was successfully completed in all patients with a mean operating room time of 154 minutes. Blood loss averaged 55 cc. Serious intraoperative or postoperative complications were not encountered in the follow-up of 6 months. Metastatic disease was demonstrated in 1 patient.
Laparoscopic pelvic lymph node dissection is technically feasible in patients who have received irradiation, and appears to confer no additional morbidity over standard laparoscopic lymphadenectomy.
本报告评估了腹腔镜盆腔淋巴结清扫术在考虑接受挽救性治疗的前列腺癌放疗患者中的可行性。
选取6名既往接受过外照射放疗且前列腺特异性抗原升高或出现临床失败的男性作为挽救性治疗的潜在候选人。采用标准菱形套管针布局进行腹腔镜检查，以评估盆腔淋巴结状况。
所有患者手术均成功完成，平均手术时间为154分钟。平均失血量为55毫升。在6个月的随访中未出现严重的术中或术后并发症。1例患者发现有转移性疾病。
腹腔镜盆腔淋巴结清扫术在接受过放疗的患者中技术上是可行的，并且与标准腹腔镜淋巴结清扫术相比，似乎不会增加额外的发病率。
