The Value Of Laparoscopic Limited And Standard Lymph Node Dissection In The Staging Of Prostate Cancer

Objective:To evaluate the clinical outcome of laparoscopic lymph node dissection in the staging of prostate cancer。Methods:From June 2007 to March 2011,21 cases of prostate cancer (group A) were selected for Laparoscopic limited pelvic lymph node dissection and 14 Patients (group B) were selected for Laparoscopic standard pelvic lymph node dissection. The pre-operation evaluation for prostate cancer was based on Gleason score and preoperative imaging studies, which could guide the scope of intraoperative lymph node dissection and avoid to damage vasculars during operation. The number of pelvic lymph node dissection, positive nodes, operating time, blood loss during operation, recovery of intestinal function postoperation, retention time of rubber drainage tube, the total hospital costs, the hospital stay time and complications during operation or postoperation were evaluated on all patients.Results:All cases have been successfully treated with Pelvic lymph node dissection. There was significant difference in the operating time and the number of positive lymph nodes between two groups. the number of pelvic lymph nodes in the group A and group B was 7.38±2.39 and 17.85±3.03 (P<0.05); the number of positive lymph nodes was0.27±0.30 and 0.92±1.94 (P<0.05), respectively; the operating time was 192.95±22.05 min and 218.14±22.72 min (P<0.05). However, the blood loss in the group A and group B was 185.0±58.4 mL and 193.8±89.2 mL (P>0.05); the recovery time of intestinal function postoperation was 61.0±13.9 hrs and 72.0±8.8 hrs (P> 0.05); the hospital stay time was 16.9±2.7 d and 18.0±3.9 d (P> 0.05), the hospitalization was RMB 19599.8±3260.6 and RMB 21448.5±3669.6 (P>0.05).Conclusions:Accurate lymph node staging will help clinicians to accurately determine the recurrence of high-risk patients and timely use of adjuvant therapy in some patients. At present, the pelvic lymph node dissection lymph node metastasis of prostate cancer is still the standard of diagnosis. Group of lymph node metastasis in patients with high risk scores, usually occurs to the multiple pelvic lymph nodes or outside lymph node metastasis (the transfer across the pathway or alternative pathway), the standard lymph node dissection is more suitable.