ABSTRACT
BACKGROUND: The objective was to carry out a prospective study to compare the current extended pelvic lymph node dissection (ePLND) to the sentinel node (SN) technique with 99mTcnanocolloid. METHODS: We conducted a prospective study between January 2013 and May 2020. In the first 74 patients, 99mTc-nanocolloid was used. Then from June 2017 onwards, in 38 patients we used a combined radiotracer prepared by adding indocyanine green (ICG). A preoperative SPECT/CT was also performed to check on the SNs. We extracted the SNs guided by a laparoscopic gamma-ray detection probe and/or a fluorescence camera. RESULTS: We included 112 patients with a Briganti nomogram-assessed risk of 5% or more. In 4 out of the total, the radiotracer did not migrate. The mean number of extracted nodes was 21.56 (13.46-29.71) and the mean of extracted SNs was 5.17 (1.83-8.51) (P<0.001). The technique that registered the most nodes with high activity was SPECT/CT, with an average of 4.33 nodes (2.42-6.23) (P<0.001). We found SNs outside the template in 78% of the patients. A total of 46% of the complications were related to ePLND. The SN biopsy showed a sensitivity of 100%, specificity of 97.5%, PVV of 92.86%, and NPV of 100%. CONCLUSIONS: Our results prove that ePLND is a technique with significant morbidity; up to 46% of the complications were related to the ePLND. The SN surgery showed great accuracy in detecting metastases due to the SPECT/CT and a lower rate of complications than ePLND.
Subject(s)
Prostatic Neoplasms , Technetium , Male , Humans , Prospective Studies , Sentinel Lymph Node Biopsy/methods , Lymph Node Excision , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/surgery , Prostatic Neoplasms/pathology , Lymph Nodes/pathology , Technetium Tc 99m Aggregated AlbuminABSTRACT
El mundo laboral se encuentra en una etapa de profundas transformaciones, cuyo efecto final aún no puede ser interpretado. La tercera revolución industrial se caracteriza por la exigencia de flexibilidad y el enorme crecimiento del sector de servicios. EStas características implican para los responsables de la seguridad y salud laboral nuevas formas de tareas. Cabe preguntarse qué aportes puede brindar la ergonomía en esta etapa económica...
Subject(s)
Occupational Health , ErgonomicsABSTRACT
El mundo laboral se encuentra en una etapa de profundas transformaciones, cuyo efecto final aún no puede ser interpretado. La tercera revolución industrial se caracteriza por la exigencia de flexibilidad y el enorme crecimiento del sector de servicios. EStas características implican para los responsables de la seguridad y salud laboral nuevas formas de tareas. Cabe preguntarse qué aportes puede brindar la ergonomía en esta etapa económica...(AU)
