One hundred consecutive laparoscopic pelvic lymph node dissections: Comparing complications of the first 50 cases to the second 50 cases

Objectives: To report the outcome of our first 100 consecutive laparoscopicpelvic lymph node dissections (LPLND) and compare the early complication rate of the first 50 cases (14%) to the second 50 cases (4%). Methods: We reviewed 100 patients who underwent LPLND. Ninety-six patients had carcinoma of the prostate and underwent LPLND prior to radical prostatectomy or definitive radiation therapy. Four patients had histologically proved penile (2) or bladder carcinoma (2) and underwent LPLND to assess their pelvic lymph nodes. Results: We encountered 7 major and minor complications in our first 50 cases, and 2 minor complications in our second 50 cases. The overall complication rate was 9% (9 of 100). Conclusions: We believe that modification of our operative technique and changes inpatient management resulted in a lower complication rate in the second 50 patients. We conclude that although LPLND has a significant learning curve, it is a viable surgical staging option for patients with urologic pelvic malignancies.