Introduction: Laparoscopic pelvic lymph node dissection is recently widely used method for surgical staging for prostate cancer. The first case in urology has been reported in 1991 from Schuessler et al.
Aim: The aim of this study was to evaluate the surgical results from our first 20 cases of laparoscopic pelvic lymph node dissection. We analyze the operative time, blood loss, intraoperative et postoperative complications, number of lymph nodes, pain, hospital stay. To compare results of the first 10 and second 10 operations.
Materials and methods: Between April 2003 and December 2006 in our Clinic have been operated 20 patients with adenocarcinoma of prostate. Median age was 64.4 years. Median prostate specific antigen was 53.7 ng/ml. Clinical methods - digital rectal examination of prostate, transrectal ultrasound punction biopsy of prostate, level of hemoglobin in blood to evaluate the blood loss. Operative method - transperitoneal laparoscopic pelvic bilateral pelvic lymph node dissection.
Results: Mean operative team for the first 10 cases was 178 minutes, and for the second 10 cases - 68.5 minutes. Hemotransfusion in first case only. No medication for pain in 6 cases, injectable medication in 7 cases and as tablet form in 3 patients. Median number of lymph nodes - 8 /0-15/. Median hospital stay 5,7 days/11-3/. No major complications, no conversion. One case of symptomatic lymphocele.
Conclusion: Laparoscopic pelvic lymph node dissection is a endoscopic method with short operative time, minimal blood loss, low level of pain, short hospital stay. The operative results are getting better after the first ten operations. This method is a useful for minimally invasive staging of prostate cancer.