Evaluation of early outcomes of extended lymphadenectomy in open radical cystectomy for bladder cancer

Tóm tắt

   Objective: Evaluation of early outcomes of extended lymphadenectomy in open radical cystectomy for bladder cancer.

   Methods: A descriptive case series study was conducted on 45 cases of extended lymphadenectomy from February 2023 to April 2024 at Binh Dan Hospital. Postoperative and 6-month follow-up outcomes were recorded, focusing on perioperative complications and early results.

   Results: The average number of lymph nodes dissected was 13.7 ± 5.7 per case. Lymph node metastasis mapping showed that the further from the bladder, the lower the rate of lymph node metastasis. Tumors located in the left wall had the lowest rate of lymph node metastasis at 18.2%, corresponding to the lowest rate of left common iliac lymph node metastasis at 18.2%. A linear relationship was observed between the stage of bladder cancer and lymph node groups: the stage of nodal metastasis increased with the advancement of the primary tumor stage. The mean duration of lymph node dissection was 51.3 ± 11.2 minutes, accounting for 19.1% of the total surgical time. The mean duration of drainage was 8.9 ± 3.6 days, while the mean postoperative hospital stay was 9.9 ± 2.5 days. The average blood loss during lymph node dissection was 40.4 ± 27.8 ml, representing 8.9% of the total surgical blood loss. There were no perioperative complications during extended lymphadenectomy. Four cases (8.9%) of lymphocele were noted at 1 month postoperatively, of which one case required percutaneous drainage, and three cases resolved spontaneously after two weeks of follow-up (Clavien I 6.7% and Clavien IIIa 2.2%).

   Conclusion: Extended lymphadenectomy in open radical cystectomy for bladder cancer is safe and feasible, contributing to accurate postoperative staging for subsequent treatment planning.

DOI: 10.59715/pntjmp.4.2.19