Morbidity of extended pelvic lymphadenectomy during robot-assisted laparoscopic prostatectomy for localized cancer prostate.

To assess the morbidity specific of extended pelvic lymphadenectomy during robot-assisted laparoscopic radical prostatectomy in a 8 year retrospective study.

We carried out a single-center, single-surgeon retrospective study on 342 consecutive patients who underwent a robot-assisted laparoscopic radical prostatectomy and extended pelvic lymphadenectomy, from July 2010 to March 2018. Postoperative complications were recorded up to 3 months after the operation.

Thirty (8.8%) patients had at least one complication related to lymphadenectomy including 1 vascular injury (0.3%), 7 injuries of the obturator nerve (2%), 5 venous thromboembolic complications (1.5%) including 4 pulmonary embolisms, 10 symptomatic lymphoceles (2.9%) and 8 lymphoedemas (2.3%). Of these complications, 13 were classified Clavien 1 (43.3%), 8 Clavien 2 (26.7%), 7 Clavien 3a (23.3%) and 2 Clavien 3b (6.7%). In univariate analysis a high age (P=0.04), high BMI (P<0.01) and pT stage (P=0.02) were significantly associated with complication whereas in multivariate analysis, only age (P=0.02) and BMI (P<0.01) lived were. In univariate analysis high BMI (P=0.04) and lymph node involvement (P=0.04) were associated with lymphatic complication. We did not find any other specific risk factor for the other complications.

With 8.8% of overall complications related to lymphadenectomy and 5% of complication classified Clavien grade 2 or higher, extended pelvic lymphadenectomy was not very morbid. Age and BMI were risk factors for a overall complication. BMI and lymph node involvement were risk factors for lymphatic complications.

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Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2022 Sep 07 [Epub ahead of print]

J Marolleau, T A Nguyen, L Doucet, A Coste, N Schoentgen, B Rousseau, A Valeri, G Fournier

Service d'urologie, CHU, Brest, France. Electronic address: ., Service d'urologie, CHU, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France; LaTIM, Inserm, UMR 1101, Université de Bretagne Occidentale, Brest, France., Laboratoire d'anatomo-pathologie, CHU, Brest, France., LaTIM, Inserm, UMR 1101, Université de Bretagne Occidentale, Brest, France; Service de médecine infectieuse et tropicale, CHU, Brest, France., Service d'urologie, CHU, Brest, France., Service d'urologie, CHU, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France; LaTIM, Inserm, UMR 1101, Université de Bretagne Occidentale, Brest, France; CeRePP, Paris, France.

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