Comparison of efficacy between extended pelvic lymph node dissection and standard pelvic lymph node dissection in laparoscopic radical cystectomy

Abstract

Objective To investigate the difference of surgical efficacy between extended lymph node dissection and standard lymph node dissection in laparoscopic radical cystectomy. Methods We retrospectively analyzed 62 bladder cancer cases, icluding 52 males and 10 females patients in our hospital from January 2011 to October 2016, who underwent laparoscopic radical cystectomy and pelvic lymph node dissection. Their mean age was (62.5±9.6)years, ranged from 42 to 83 years.27 cases were underwent extended lymph node dissection and 35 cases were underwent standard lymph node dissection respectively. The basic characters, operative time, intraoperative blood loss, intraoperative and postoperative complications, postoperative eating time, postoperative activity time, postoperative hospital stay, lymph nodes positive rate, lymph node density, and cancer-free survival were evaluated. Results All patients were underwent successful operation. There was no significant difference in operation time[(326.2±77.5)min vs. (345.5±66.8)min, P=0.297], blood loss[ (198.2±77.5)ml vs. (213.7±160.0)ml, P= 0.590], intraoperative complications(0/27 vs. 5/35, F=0.063), postoperative complications(8/27 and 9/35, P=0.732), postoperative eating time[ (4.8±2.2)d vs.(4.6±1.9)d, P=0.817], postoperative activity time[ (1.9±0.8)d vs. (1.9±0.9)d, P=0.838]and postoperative hospital stay[ (15.6±7.5)d vs. (16.0±5.9)d, P=0.483]. In this study, 994 lymph nodes and 100 positive lymph nodes were dissected. There were significant differences in the number of lymph nodes dissected in the two groups (23.2±6.6 vs. 10.5±3.6, P 0.05), DFS of ePLND group tended to be higher than that of sPLND group in lymph node positive subgroups. Conclusions Extended lymph node dissection and standard lymph node dissection have similar surgical safety and prognosis, and appropriate surgical procedures should be selected according to the patient′s condition. Key words: Laparoscopic radical cystectomy; Lymph node dissection; Safety; Prognosis