Pelvic lymph nodes dissection for prostate cancer: Minilap with speculum vs laparoscopy

Introduction. The pelvic lymph nodes dissection (PLND) is indicated in case of prostate cancer with high risk of ganglionic metastasis. Criteria admitted for indication of PLND are PSA >= 10 ng/ml and/or Gleason score >= 7. Two techniques are available for PLND: minilap and laparoscopy. The purpose of this study was to compare retrospectively minilap and the 2 ways of laparoscopy: intra- and extraperitoneum, in terms of efficiency and complications. Material and method. We reviewed 147 cases of men who's had a PLND in our department between 1992 and 2006. The distribution for every technique was: 34 cases of minilap (23%), 39 cases of intraperitoneum laparoscopy (27%) and 74 cases of extraperitoneum laparoscopy (50%). The mean age was of 67.9 years (52-79). The mean PSA was 19.01 ng/ml (0.3-93) and the average Body Mass Index (BMI) was 26.75 kg m(-2) (17.6-41). Results. Twenty-eight patients (19%) presented a postoperating complication. There was no statistically significant difference according to technique. We did not either find statistical difference concerning the number of analyzed nodes between three groups and the duration of hospitalization. Only the mean operating time and the number of drain of Redon were statistically different. Conclusion. This study did not show any difference in terms of result and complications between the laparoscopy and minilap for the PLND in case of prostate cancer. We think each technique could be proposed. (C) 2009 Elsevier Masson SAS. All rights reserved.