LAPAROSCOPIC PELVIC LYMPHADENECTOMY: WHO SHOULD GET IT? WHO SHOULDN’T GET IT?
Who Should Get It? Some doctors recommend laparoscopic pelvic lymphadenectomy in men who are at higher risk of having cancer that has spread beyond the prostate. This group includes men with stage B2 or B3 disease, high Gleason scores (8, 9, 10); elevated acid phosphatase levels; or a PSA score higher than 20. It also is recommended for some men who opt for radiation therapy—particularly, those for whom open surgery would be too risky.
Who Shouldn’t Get It? Even minimally invasive surgery can be complicated and potentially dangerous in men with other health problems. These include: Men with a history of Crohn’s disease, peritonitis, intestinal obstruction, heart or lung disease, impaired blood flow, or a hernia in the diaphragm. It’s possible, too, that just having had previous surgery may cause complications in a laparoscopic procedure. (Indeed, if you have had any other health problems, make sure your doctor knows about it before you undergo any procedure!) Also, any man with apparent localized disease and a low probability of lymph node involvement who is planning to undergo a radical retropubic prostatectomy does not need this procedure.
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