ABSTRACT
OBJECTIVES: To report the outcome of our first 100 consecutive laparoscopic pelvic lymph node dissections (LPLND) and compare the early complication rate of the first 50 cases (14%) to the second 50 cases (4%). METHODS: We reviewed 100 patients who underwent LPLND: Ninety-six patients had carcinoma of the prostate and underwent LPLND prior to radical prostatectomy or definitive radiation therapy. Four patients had histologically proved penile (2) or bladder carcinoma (2) and underwent LPLND to assess their pelvic lymph nodes. RESULTS: We encountered 7 major and minor complications in our first 50 cases, and 2 minor complications in our second 50 cases. The overall complication rate was 9% (9 of 100). CONCLUSIONS: We believe that modification of our operative technique and changes in patient management resulted in a lower complication rate in the second 50 patients. We conclude that although LPLND has a significant learning curve, it is a viable surgical staging option for patients with urologic pelvic malignancies.
Subject(s)
Laparoscopy/adverse effects , Lymph Node Excision/adverse effects , Lymph Node Excision/methods , Follow-Up Studies , Humans , Male , Pelvis , Penile Neoplasms/surgery , Postoperative Complications/epidemiology , Prostatic Neoplasms/surgery , Urinary Bladder Neoplasms/surgeryABSTRACT
The combination of diazepam plus pethidine, reversed with naloxone, was compared in a double-blind randomized study with diazepam alone in 100 patients undergoing endoscopy. Patients accepted both methods of sedation equally well. There was no significant difference in sedation after endoscopy, but the addition of pethidine produced a significant improvement in patient co-operation during the endoscopy (P less than 0.001).
