Comparation Of En Bloc And Separate Pelvic Lymph Node Dissection In Laparoscopic Radical Cystectomy

Objective:To explore a more advantageous method of pelvic lymph tissue dissection, we compared the clinical efficacy of separate and en bloc pelvic lymph node dissection in laparoscopic radical cystectomy.Methods:138 bladder cancer patients were analysed, who were treated by laparoscopic radical cystectomy and pelvic lymph node dissection in our hospital from 2009 January to 2015 March.92 of them underwent the en bloc pelvic lymph node dissection method,46 patients were performed by separate resection method. In order to evaluate two methods of pelvic lymph node dissection, we compared the operation time, amount of bleeding, lymph node positive rate and lymph node density between the en bloc resection method and separate resection.Results:the operation time of en bloc resection was average 66 ± 10min, another group was 70 ± 10min, there was no significant difference in operation time of the two methods (P=0.12). The amount of intraoperative bleeding in en bloc resection method was 44+18 ml, which was significantly less than packet excision bleeding of 81 ± 30ml (P< 0.001). The lymph node obtained by en bloc resection was average 13.9 ± 3.7, which was significantly higher than that of separate removal group of 6.0 ± 3.8 (P< 0.001). The lymph node positive rate of en bloc resection group was 20%, while separate resection group was 22%, the two groups had no significant difference in lymph node positive rate (P=0.89), but there was statistical significance of lymph node density between the two groups (P=0.002), lymph node density of en bloc resection and separate resection method were 11% and 17%, respectively.Conclusion:1. In laparoscopic radical cystectomy, en bloce pelvic lymph node excision method was significantly better than separate pelvic lymph node dissection method in the aspect of reducing the amount of bleeding.2. By comparing this two method, we found that the number of en bloc lymph nodes resection increased significantly.3.The lymph node density difference was statistically significant between the two method, because en bloc pelvic lymph node dissection can get more lymph nodes than separate pelvic lymph node dissection.