Effert P, Boeckmann W, Wolff J, Jakse G
Urologische Klinik der RWTH Aachen.
Urologe A. 1996 Sep;35(5):413-7. doi: 10.1007/s001200050043.
Laparoscopic pelvic lymph node dissection was performed in 120 patients scheduled to undergo either radical perineal prostatectomy or radiation therapy. On average 13 lymph nodes were resected in each patient, and 21 patients were found to have metastatic disease in 1-9 lymph nodes. After an initial learning curve, mean operative time was reduced significantly, allowing laparoscopic lymph node dissection and radical prostatectomy to be performed as a one-stage procedure. The overall complication rate was 10%; open revisions were necessary in only 2 of 120 patients. Postoperative hospital stay was 2 days in patients undergoing laparoscopic lymph node dissection only. This minimally invasive procedure is particularly beneficial to patients with lymph node metastases not undergoing radical prostatectomy, as well as to patients planned to be treated by radiation therapy. The combination of laparoscopic lymph node dissection and radical perineal prostatectomy avoids an abdominal incision and thus shortens both the hospital stay and the period of convalescence.
对120例计划接受根治性会阴前列腺切除术或放射治疗的患者进行了腹腔镜盆腔淋巴结清扫术。平均每位患者切除13个淋巴结,发现21例患者在1 - 9个淋巴结中有转移性疾病。经过最初的学习曲线后,平均手术时间显著缩短,使得腹腔镜淋巴结清扫术和根治性前列腺切除术能够作为一期手术进行。总体并发症发生率为10%;120例患者中仅2例需要进行开放修复。仅接受腹腔镜淋巴结清扫术的患者术后住院时间为2天。这种微创手术对未接受根治性前列腺切除术的淋巴结转移患者以及计划接受放射治疗的患者特别有益。腹腔镜淋巴结清扫术和根治性会阴前列腺切除术的联合避免了腹部切口,从而缩短了住院时间和康复期。