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Richard S. Foster - One of the best experts on this subject based on the ideXlab platform.
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Postchemotherapy retroperitoneal Lymph Node Dissection for testis cancer.
Expert review of anticancer therapy, 2011Co-Authors: Michael C. Risk, Richard S. FosterAbstract:The treatment of patients with metastatic testicular cancer is multimodal. Postchemotherapy retroperitoneal Lymph Node Dissection is a technically demanding procedure that can benefit appropriately selected patients. In this article, we review postchemotherapy retroperitoneal Lymph Node Dissection, including indications, technical updates, and the management and outcomes of patients who undergo surgery. Many aspects continue to evolve, and we review the evidence regarding current controversies in the field.
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RETROPERITONEAL Lymph Node Dissection FOR THE MANAGEMENT OF CLINICAL STAGE I NONSEMINOMA
The Journal of urology, 2000Co-Authors: Richard S. Foster, John P. DonohueAbstract:Purpose: We review the rationale for the use of retroperitoneal Lymph Node Dissection for clinical stage I nonseminomatous testis cancer.Materials and Methods: The published literature regarding the alternative treatments for clinical stage I nonseminoma was reviewed as well as the personal experience of the authors to define the role of retroperitoneal Lymph Node Dissection.Results: Retroperitoneal Lymph Node Dissection alone is curative in 50% to 75% of patients with pathological stage II disease. The only significant long-term morbidity is a 1% chance of small bowel obstruction. If recurrence develops after retroperitoneal Lymph Node Dissection, it is virtually always curable with cisplatin based chemotherapy.Conclusions: Retroperitoneal Lymph Node Dissection retains a therapeutic and staging capability in these patients. The probability for cure, short and long-term morbidity, and minimal need for long-term followup in these patients indicates that retroperitoneal Lymph Node Dissection continues to be...
Daniel B. Rukstalis - One of the best experts on this subject based on the ideXlab platform.
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Robotic-assisted laparoscopic retroperitoneal Lymph Node Dissection.
Urology, 2006Co-Authors: Patrick Davol, Joel M. Sumfest, Daniel B. RukstalisAbstract:Minimally invasive laparoscopic techniques have been applied to the staging and treatment of testicular cancer during the performance of retroperitoneal Lymph Node Dissection. The da Vinci Surgical System potentially improves the safety and accuracy of this approach. We present what we believe to be the first published description of robotic-assisted retroperitoneal Lymph Node Dissection, which was performed in an 18-year-old man with a mixed germ cell tumor. This case demonstrates the technical feasibility, safety, and accuracy of robotic-assisted retroperitoneal Lymph Node Dissection and expands the role of minimally invasive techniques in urologic oncology.
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Laparoscopic approach to retroperitoneal Lymph Node Dissection.
Seminars in surgical oncology, 1996Co-Authors: Glenn S. Gerber, Daniel B. RukstalisAbstract:Laparoscopic retroperitoneal Lymph Node Dissection is a new surgical procedure used to enhance staging in men with clinical stage I nonseminomatous germ cell tumors of the testis. The procedure has been performed in a limited number of patients at several centers with extensive laparoscopic experience. Laparoscopic retroperitoneal Lymphadenectomy is a technically demanding procedure which can be successfully completed in the majority of patients. However, the risk of complications is greater than in patients who undergo standard open retroperitoneal Lymph Node Dissection. The primary advantage of a laparoscopic approach is shortened hospitalization and rapid return to normal activity. The role of laparoscopy in the management of patients with testis malignancy has not been defined. The use of this staging procedure may help minimize the need for surveillance studies following surgery and may be best utilized in men with a lower likelihood of nodal metastases. Ultimately, prospective study in large groups of patients will be necessary to determine the role of laparoscopic retroperitoneal Lymph Node Dissection in patients with testis cancer.
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Laparoscopic Pelvic Lymph Node Dissection: A Review of 103 Consecutive Cases
The Journal of urology, 1994Co-Authors: Daniel B. Rukstalis, Glenn S. Gerber, Nicholas J. Vogelzang, Daniel J. Haraf, Francis H. Straus, Gerald W. ChodakAbstract:AbstractLaparoscopic pelvic Lymph Node Dissection is a recently introduced technique for the surgical evaluation of the regional pelvic Lymph Nodes in genitourinary malignancies. We report the results of a laparoscopic pelvic Lymph Node Dissection performed on 103 consecutive patients for staging of clinically localized prostatic, bladder and penile carcinomas. In 20 patients (group 1) the adequacy of the laparoscopic pelvic Lymph Node Dissection was evaluated with a subsequent open Dissection. In this group 87 to 95% of the Lymph Nodes within a modified template could be reliably removed laparoscopically. In 73 patients (group 2) laparoscopic pelvic Lymph Node Dissection was performed as a solitary operation. Mean hospitalization was 1.6 ± 2.4 days, while postoperative narcotic requirements were minimal. Mean operative time for bilateral laparoscopic pelvic Lymph Node Dissection was 156 ± 41.2 minutes. The overall complication rate in these 2 groups was 13.5%. Group 3 includes 10 patients (9.7% of the to...
Günter Janetschek - One of the best experts on this subject based on the ideXlab platform.
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Laparoscopic and robotic postchemotherapy retroperitoneal Lymph Node Dissection.
Current opinion in urology, 2014Co-Authors: Thomas Kunit, Günter JanetschekAbstract:PURPOSE OF REVIEW Open surgical postchemotherapy retroperitoneal Lymph Node Dissection remains the standard of care. On the contrary, laparoscopy is an emerging technique and reports of laparoscopic Lymph Node Dissection postchemotherapy are increasing. Our purpose is to present indications, technique and outcomes of laparoscopic postchemo retroperitoneal Lymph Node Dissection. RECENT FINDINGS With growing expertise and knowledge the morbidity of the laparoscopic approach is much reduced compared with open surgery with the same oncological outcome. Robotic surgery is a more recent approach with growing usage in urology. However, no reports of robotic postchemotherapy Lymph Node Dissection are available. SUMMARY In expert hands laparoscopic Lymph Node Dissection is a feasible technique, offering less morbidity to patients with good oncological results.
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Can sentinel pelvic Lymph Node Dissection replace extended pelvic Lymph Node Dissection in patients with prostate cancer?
Nature Clinical Practice Urology, 2007Co-Authors: Günter JanetschekAbstract:Sentinel pelvic Lymph Node Dissection is a radioisotope-guided technique that has been developed for the detection of potential Lymph Node metastases. In this Viewpoint, Professor Janetschek discusses the possibility that sentinel pelvic Lymph Node Dissection could replace extended pelvic Lymph Node Dissection in patients with prostate cancer.
Urs E. Studer - One of the best experts on this subject based on the ideXlab platform.
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Extended Lymph Node Dissection for prostate cancer
Current urology reports, 2008Co-Authors: Stephan Jeschke, Fiona C. Burkhard, Ramesh Thurairaja, Nivedita Dhar, Urs E. StuderAbstract:Lymph Node status is an important determinant for the management of patients with newly diagnosed prostate cancer. Given the significant limitations of cross-sectional and functional preoperative imaging in the detection of small metastases, pelvic Lymph Node Dissection remains the only reliable staging method in clinically localized prostate cancer. Although Lymph Node Dissection is a well-established form of staging in prostate cancer, controversy remains about indications and the surgical extent of the procedure. Reported practices vary from omitting pelvic Lymph Node Dissection in low-risk disease to routine pelvic Lymph Node Dissection in all radical prostatectomy patients. This review highlights the recent literature concerning pelvic Lymphadenectomy in prostate cancer with respect to anatomical extent and oncologic outcome.
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outcome after radical cystectomy with limited or extended pelvic Lymph Node Dissection
The Journal of Urology, 2008Co-Authors: Nivedita Dhar, Eric A Klein, Alwyn M Reuther, George N Thalmann, Stephan Madersbacher, Urs E. StuderAbstract:Purpose: We compared recurrence patterns and survival of patients with urothelial bladder cancer undergoing radical cystectomy who either had limited or extended pelvic Lymph Node Dissection at 2 institutions between 1987 and 2000.Materials and Methods: Two consecutive series of patients treated with radical cystectomy and limited pelvic Lymph Node Dissection (336; Cleveland Clinic) and extended pelvic Lymph Node Dissection (322; University of Bern) were analyzed. All cases were staged N0M0 prior to radical cystectomy, and none were treated with neoadjuvant radiotherapy or chemotherapy. Patients with PTis/pT1 and pT4 disease were excluded from analysis. Pathological characteristics based on the 1997 TNM system and recurrence patterns were determined.Results: The overall Lymph Node positive rate was 13% for patients with limited and 26% for those who had extended pelvic Lymph Node Dissection. The 5-year recurrence-free survival of patients with Lymph Node positive disease was 7% for limited and 35% for ext...
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is a limited Lymph Node Dissection an adequate staging procedure for prostate cancer
The Journal of Urology, 2002Co-Authors: Pia Bader, Fiona C. Burkhard, Regula Markwalder, Urs E. StuderAbstract:Purpose: Generally Lymph Node Dissection is only considered a staging procedure for prostate cancer. Therefore, the need for meticulous Lymph Node Dissection is often questioned and only sampling is suggested. We performed a prospective study to identify the pattern of Lymph Node metastasis in prostate cancer and determine how extensive Lymph Node Dissection must be not to under stage cases.Materials and Methods: All patients with clinically organ confined prostate cancer, no prior hormonal treatment, negative preoperative staging computerized tomography and bone scan, who underwent radical prostatectomy between 1989 and 1999, were evaluated prospectively as to the number and location of Lymph Node metastasis. A meticulous Lymph Node Dissection was performed along the external iliac vein, obturator nerve and internal iliac (hypogastric) vessels. Nodes from each location and side were submitted separately for histological evaluation.Results: In 365 patients with a median serum prostate specific antigen of ...
Michael C. Risk - One of the best experts on this subject based on the ideXlab platform.
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Postchemotherapy retroperitoneal Lymph Node Dissection for testis cancer.
Expert review of anticancer therapy, 2011Co-Authors: Michael C. Risk, Richard S. FosterAbstract:The treatment of patients with metastatic testicular cancer is multimodal. Postchemotherapy retroperitoneal Lymph Node Dissection is a technically demanding procedure that can benefit appropriately selected patients. In this article, we review postchemotherapy retroperitoneal Lymph Node Dissection, including indications, technical updates, and the management and outcomes of patients who undergo surgery. Many aspects continue to evolve, and we review the evidence regarding current controversies in the field.
