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- W2023651938 abstract "No AccessJournal of UrologyAdult Urology1 Jan 2011Robot Assisted Extended Pelvic Lymphadenectomy at Radical Cystectomy: Lymph Node Yield Compared With Second Look Open Dissection John W. Davis, Kris Gaston, Roosevelt Anderson, Colin P.N. Dinney, H. Barton Grossman, Mark F. Munsell, and Ashish M. Kamat John W. DavisJohn W. Davis Financial interest and/or other relationship with Genprobe. More articles by this author , Kris GastonKris Gaston More articles by this author , Roosevelt AndersonRoosevelt Anderson More articles by this author , Colin P.N. DinneyColin P.N. Dinney Financial interest and/or other relationship with AstraZeneca, National Cancer Institute, Schering Plough, Spectrum and Novartis. More articles by this author , H. Barton GrossmanH. Barton Grossman Financial interest and/or other relationship with PhotoCure, GE Healthcare, Ferring, Viventia, Abbott Molecular, OncoMethylome and Tengion. More articles by this author , Mark F. MunsellMark F. Munsell More articles by this author , and Ashish M. KamatAshish M. Kamat Financial interest and/or other relationship with Adalor, Bioniche, Celgene, Bioste, Endo, Tetralogic, AstraZeneca and Precision Therapeutics. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.09.031AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Robot assisted radical cystectomy outcomes show feasibility and potential benefits for patient recovery. However, it is difficult to judge the completeness of extended robot assisted vs open pelvic lymph node dissection using only the lymph node count and template description. We performed a prospective protocol in which radical cystectomy and pelvic lymph node dissection done in robot assisted fashion were followed by second look open pelvic lymph node dissection. Our primary objective was to determine the fraction of lymph nodes yielded by robot assisted pelvic lymph node dissection. Materials and Methods: Patients with pure transitional cell carcinoma and no locally advanced features were selected for robot assisted radical cystectomy. A team of 2 urological oncologists performed radical cystectomy and pelvic lymph node dissection in robot assisted fashion, followed by second look open pelvic lymph node dissection. Lymph nodes from robot assisted dissection were submitted in up to 8 separate specimens by anatomical location. Any additional specimens retrieved at open dissection were submitted separately. Results: The protocol was completed in 11 patients from October 2007 to June 2009. The median yield of robot assisted and second look open pelvic lymph node dissection was 43 (range 19 to 63) and 4 (range 0 to 8), respectively, for an overall robot assisted yield of 93%. Of second look open pelvic lymph node dissections 67% were clear of residual tissue, 13% had tissue without lymph nodes and 20% had 1 or more lymph nodes. Median operative time for robot assisted pelvic lymph node dissection was 117 minutes. Concurrently open radical cystectomy without required multiple lymph node specimen submission yielded a median 24 nodes. Conclusions: Our data showing a robot assisted pelvic lymph node dissection yield of 93% of that of open surgery should allay concern that the robot assisted technique limits the completeness of pelvic lymph node dissection. References 1 : Laparoscopic radical cystectomy: formidable challenge to the gold standard. J Endourol2008; 22: 2069. Google Scholar 2 : Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol2001; 19: 666. Google Scholar 3 : A critical analysis of perioperative mortality from radical cystectomy. J Urol2006; 175: 886. 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Link, Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByNavai N and Dinney C (2018) Oncologic Equivalence between Laparoscopic/Robotic and Open Radical CystectomyJournal of Urology, VOL. 195, NO. 6, (1646-1647), Online publication date: 1-Jun-2016.Parekh D, Messer J, Fitzgerald J, Ercole B and Svatek R (2018) Perioperative Outcomes and Oncologic Efficacy from a Pilot Prospective Randomized Clinical Trial of Open Versus Robotic Assisted Radical CystectomyJournal of Urology, VOL. 189, NO. 2, (474-479), Online publication date: 1-Feb-2013.Abaza R, Dangle P, Gong M, Bahnson R and Pohar K (2018) Quality of Lymphadenectomy is Equivalent With Robotic and Open Cystectomy Using an Extended TemplateJournal of Urology, VOL. 187, NO. 4, (1200-1205), Online publication date: 1-Apr-2012.Morgan T, Kaffenberger S and Cookson M (2018) Surgical and Chemotherapeutic Management of Regional Lymph Nodes in Bladder CancerJournal of Urology, VOL. 188, NO. 4, (1081-1088), Online publication date: 1-Oct-2012. Volume 185Issue 1January 2011Page: 79-84 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordscarcinoma cystectomyurinary bladderlymph node excisionroboticsMetricsAuthor Information John W. Davis Financial interest and/or other relationship with Genprobe. More articles by this author Kris Gaston More articles by this author Roosevelt Anderson More articles by this author Colin P.N. Dinney Financial interest and/or other relationship with AstraZeneca, National Cancer Institute, Schering Plough, Spectrum and Novartis. More articles by this author H. Barton Grossman Financial interest and/or other relationship with PhotoCure, GE Healthcare, Ferring, Viventia, Abbott Molecular, OncoMethylome and Tengion. More articles by this author Mark F. Munsell More articles by this author Ashish M. Kamat Financial interest and/or other relationship with Adalor, Bioniche, Celgene, Bioste, Endo, Tetralogic, AstraZeneca and Precision Therapeutics. More articles by this author Expand All Advertisement PDF DownloadLoading ..." @default.
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