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Extended lymph node dissection in robot-assisted radical prostatectomy: lymph node yield and distribution of metastases

Authors
 Kwang Hyun Kim  ;  Sey Kiat Lim  ;  Kyo Chul Koo  ;  Woong Kyu Han  ;  Sung Joon Hong  ;  Koon Ho Rha 
Citation
 ASIAN JOURNAL OF ANDROLOGY, Vol.16(6) : 824-828, 2014 
Journal Title
 ASIAN JOURNAL OF ANDROLOGY 
ISSN
 1008-682X 
Issue Date
2014
MeSH
Aged ; Humans ; Lymph Node Excision* ; Lymphatic Metastasis* ; Male ; Middle Aged ; Prostatectomy* ; Prostatic Neoplasms/pathology* ; Robotics*
Abstract
In this study, we reported our experience performing robotic extended lymph node dissection (eLND) in patients with prostate cancer. A total of 147 patients with intermediate and high-risk prostate cancer who underwent robotic eLND from May 2008 to December 2011 were included in this analysis. The dissection template extended to the ureter crossing the iliac vessels. We assessed lymph node yield, lymph node positivity, and perioperative outcomes. Lymph node positivity was also evaluated according to the number of lymph nodes (LNs) removed (<22 vs ≥22). The median number of LNs removed was 22 (11-51), and 97 positive LNs were found in 24 patients (16.3%). While the obturator fossa was the most common site for LN metastases (42.3%, 41/97), the internal iliac area was the most common area for a single positive LN packet (20.8%, 5/24). Eight patients (33.3%, 8/24) had positive LNs at the common iliac area. The incidence of positive LNs did not differ according to the number of LNs removed. Complications associated with eLND occurred in 21 patients (14.3%) and symptomatic lymphocele was found in five patients (3.4%). In conclusion, robotic eLND can be performed with minimal morbidity. Furthermore, LN yield and the node positive rate achieved using this robotic technique are comparable to those of open series. In addition, the extent of dissection is more important than the absolute number of LNs removed in eLND, and the robotic technique is not a prohibitive factor for performing eLND
Files in This Item:
T201404512.pdf Download
DOI
10.4103/1008-682X.133319
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Kim, Kwang Hyun(김광현)
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Lim, Sey Kiat(임세이캣)
Han, Woong Kyu(한웅규) ORCID logo https://orcid.org/0000-0002-2527-4046
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138388
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