Comparison of Extraperitoneal and Transperitoneal Pelvic Lymph Node Dissection During Minimally Invasive Radical Prostatectomy

Mullins, Jeffrey K.; Hyndman, M. Eric; Mettee, Lynda Z.; Pavlovich, Christian P.

doi:10.1089/end.2011.0209

Cited by 10 publications

(1 citation statement)

References 23 publications

(21 reference statements)

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“…Yet the potential curative effect of PLND has not been proved with certainty. Examination of large series of patients with varied risk for LN metastases has failed to prove that PLND alters significantly the biochemical relapse-free survival of the disease [ 31 – 33 ]. The latter could possibly be explained by the fact that even extended PLND fails to retrieve the entire lymph node network draining from the prostate, and as a result, the possibility through a radical prostatectomy and a combining extensive LN resection to extract all spreading cancer cells is very limited.…”

Section: Pelvic Lymph Node Dissection During Lerpmentioning

confidence: 99%

Comments on the Extraperitoneal Approach for Standard Laparoscopic Radical Prostatectomy: What Is Gained and What Is Lost

et al. 2011

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Laparoscopic extraperitoneal radical prostatectomy (LERP) is considered the standard care treatment option for the management of localized and locally advanced prostatic cancer (PCa) in many institutes worldwide. In this work, the main advantages and disadvantages of LERP approach are reviewed with regard to its outcomes, the complication management, the learning curve, and the extend of pelvic lymph node dissection (PLND). It is concluded that LERP demonstrates comparable cancer control, urinary continence, and potency outcomes with the open and the robot-assisted radical prostatectomy, while offering advantages in complication management in comparison to the transperitoneal approach. Learning curve of LERP is considered long and stiff and significantly affects perioperative outcomes and morbidity, cancer control, and functional results. Thus, close mentoring especially in the beginning of the learning curve is advised. Finally, LERP still has a role in the limited or modified PLND offered in intermediate risk PCa patients.

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Section: Pelvic Lymph Node Dissection During Lerpmentioning

confidence: 99%