機器人手臂輔助腹腔鏡攝護腺切除手術
是否需移除攝護腺前脂肪組織偵測淋巴轉移？
陳嘉宏1、鍾孝仁1,2,3、林子平1,2,3、黃逸修1,2,3、黃志賢1,2,3、
、張延驊1,2,3、林登龍1,2,3、陳光國1,2,3
Does it need to remove pre-prostatic fat to detected lymph node metastasis of prostate cancer during robotic assisted radical prostatectomy?
Chia-Hung Chen1, Hsiao-Jen Chung1,2,3, Tzu-Ping Lin1,2,3, Eric YH Huang1,2,3, William JS Huang, 1,2,3, Yen-Hwa Chang1,2,3, Alex TL Lin1,2,3, Kuang-Kuo Chen1,2,3
1Department of Urology, Taipei Veterans General Hospital, Taipei , Taiwan; 2Department of Urology, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 3Shu-Tien Urological Science Research Center , Taipei, Taiwan
Purpose:
To determine the number of lymph node of pre-prostatic fat and the incidence of metastatic lymph nodes in the lymph node dissection during robotic assisted radical prostatectomy(RARP)
Materials and Methods:
During December 2012 to September 2015, pre-prostatic fat was removed in182 patients who underwent RARP. These tissues were sent for pathological analysis to determinate the number of lymph nodes and the count of metastatic lymph nodes. Another 128 patients without pre-prostatic fat removal were collected as control group. Operation features, such as time consumption of operation, estimated blood loss, day of hospitalization, and incidence of complication were compared within these two groups.
Results:
Lymph nodes within pre-prostatic fat were detected in 17/188(9%) patients. Metastatic lymph node was found in 2/188 (1%) among these patients. Patients with metastatic lymph nodes in pre-prostatic fat had no obturator lymph nodes involved. There were no significant differences of operation features between experimental and control group.
Conclusions:
Our analysis demonstrates that pre-prostatic fat contains lymph nodes. The rate of present of lymph node metastases was high. There was no increasing of the risk of surgery for Pre prostatic fat removal. Therefore, It should be routinely removed and received pathological analysis at radical prostatectomy for precise lymph node staging