医学
前列腺切除术
解剖(医学)
淋巴结切除术
淋巴结
前列腺癌
外科
髂外静脉
神经血管束
髂内动脉
放射科
髂外动脉
泌尿科
癌症
静脉
病理
内科学
作者
Daniar Osmonov,Chaojun Wang,Jorg Hoenle,А. С. Аксенов,Claudius Hamann,Carsten Maik Naumann,Klaus‐Peter Juenemann
出处
期刊:Urology
[Elsevier]
日期:2011-04-01
卷期号:77 (4): 969-974
被引量:11
标识
DOI:10.1016/j.urology.2010.06.071
摘要
To describe a surgical technique of pelvic lymph node dissection (PLND) in prostate cancer patients. The idea was to standardize the procedure of PLND and to increase the significance of lymphadenectomy as a part of radical prostatectomy (RP). The best ways to achieve this are (1) to describe the surgical procedure in detail, (2) to improve the knowledge of metastatic spread, and (3) to improve the management of complications.One-hundred six patients with localized prostate carcinoma were treated with RP, including extended PLND. The number of removed lymph nodes (LNs) was correlated with histology and compared with that reported in the literature. Our aim was to observe technical differences that probably accrue in clinical outcomes. We proposed a conceptual schema of PLND.LN metastases were detected in 15 of 106 patients (14.15%). Positive sentinel LNs were detected in 11 of these 15 patients (73.3%). The average number of removed LNs was 20.5 (range +5). In 4 of 15 patients (26.5%), positive LNs were found in the fossa obturatoria; in 4 patients (26.5%) in the region of the external iliac artery; in 3 patients (20%) in the internal LN region; in 2 patients (13%) in the region of the common iliac artery; in 1 patient (7%) in the presciatic area; and in 1 patient (7%) in the sacral region.The standard routine was: (1) dissection of LN tissue along the common iliac artery, (2) dissection of LN tissue in the presciatic area, (3) dissection of LN tissue parasacral, and (4) peritoneal fenestration.
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