Management of external iliac metastatic lymph nodes during laparoscopic radical cystectomy
Zhu Juncheng1, Li Jiongming1, Liu Jianhe1, Liu Kaiming2, Jiang Yongming1, Fang Kewe1, Wang Guang1, Li Pei1, Shi Xin1, Prashant1, Duan Fei1
1Department of Urology, Second Affiliated Hospital of Kunming Medical University, Kunming 650101, China; 2Department of Urology, Luliang County People's Hospital
Abstract：Objective: To explore the management of metastatic lymph node during laparoscopic radical cystectomy. Methods: From September 2012 to October 2017, 12 patients underwent radical cystectomy and lymphadenectomy for invasive bladder cancer and lymph node metastasis of iliac vessel. Before lymph node dissection, the proximal end of external iliac artery or common iliac artery and distal end of external iliac vein were fully anatomized, vessels were fully occluded, and the lymph nodes were dissociated and dissected along the vascular sheath and blood vessels. Results: All 12 patients underwent laparoscopic lymphadenectomy invading the iliac vessels. Time of unilateral removal of lymph node was 15-35 min. There was 1 case of external iliac vein injury. No injury of external iliac artery and no serious bleeding occurred. No postoperative bleeding and external iliac venous embolism occurred. Conclusions: If we fully occluded the external iliac artery and vein, we can safely and effectively remove the larger metastatic iliac lymph nodes completely.
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