| Incidence of lymphoceles after robot-assisted pelvic lymph node dissection. | |
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MedLine Citation:
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PMID: 21489117 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: • To determine the incidence and predictive factors of lymphocele formation in patients undergoing pelvic lymph node dissection (PLND) during robot-assisted radical prostatectomy (RARP). PATIENTS AND METHODS: • Between April and December 2008, 76 patients underwent PLND during RARP for ≥cT2c, prostate-specific antigen level ≥10, Gleason score ≥7 prostate cancer. • All patients were prospectively followed up with pelvic computed tomography 6-12 weeks after the procedure. • All patients received s.c. heparin preoperatively and postoperatively. PLND was limited to zones 1 and 2 as defined by Studer. • Plasma-kinetic bipolar forceps were used for haemostasis during PLND. RESULTS: • At a mean follow-up of 10.8 weeks, 51% (39/76) of patients had developed a lymphocele. Of these 39 lymphoceles 32 (82%) were unilateral and seven (18%) were bilateral. • The mean (range) lymphocele size was 4.3 × 3.2 (1.5-12.3) cm; 41% of lymphoceles were <4 cm, 53.9% were 4-10 cm, and 5.1% were >10 cm in diameter. Six of the 39 lymphoceles (15.4%) were clinically symptomatic. The symptoms were as follows: pelvic pressure in five patients, abdominal distension with ileus in three patients, leg pain/weakness in one patient and costovertebral tenderness in one patient. Two lymphoceles required intervention. • On the logistic regression model the presence of nodal metastases, tumour volume in the prostate specimen and extracapsular extension (ECE) were independent risk factors for the development of a lymphocele. • There was no correlation between estimated blood loss, body mass index, pathological Gleason score or number nodes dissected and the presence of lymphocele. CONCLUSIONS: • The incidence of lymphoceles was higher than anticipated given the believed protective effect of the transperitoneal approach against lymphocele formation. • The risk of lymphocele seemed to increase linearly with the presence of more extensive disease, particularly ECE and nodal involvement. • The benefit of PLND during RARP should be weighed against the elevated risk of lymphocele formation and its potential complications. |
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Authors:
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Marcelo A Orvieto; Rafael F Coelho; Sanket Chauhan; Kenneth J Palmer; Bernardo Rocco; Vipul R Patel |
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Publication Detail:
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Type: Journal Article Date: 2011-04-12 |
Journal Detail:
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Title: BJU international Volume: 108 ISSN: 1464-410X ISO Abbreviation: BJU Int. Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-09-14 Completed Date: 2011-11-08 Revised Date: 2012-03-26 |
Medline Journal Info:
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Nlm Unique ID: 100886721 Medline TA: BJU Int Country: England |
Other Details:
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Languages: eng Pagination: 1185-90 Citation Subset: IM |
Copyright Information:
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© 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL. |
Affiliation:
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University of Chicago, Department of Surgery, Section of Urology, Chicago, IL, USA. marceloorvieto@yahoo.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Humans Incidence Lymph Node Excision / adverse effects*, methods* Lymphatic Metastasis Lymphocele / epidemiology*, etiology* Male Middle Aged Pelvis Prospective Studies Prostatic Neoplasms / pathology, surgery* Robotics* |
| Comments/Corrections | |
Comment In:
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BJU Int. 2011 Oct;108(7):1190
[PMID:
21489120
]
BJU Int. 2012 Mar;109(5):E14 [PMID: 22339999 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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