Magnus Annerstedt

University of Copenhagen Herlev Hospital, Herlev, Capital Region, Denmark

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Publications (2)0 Total impact

  • Magnus Annerstedt, Alex Mottrie
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    ABSTRACT: Pelvic lymph node dissection (PLND) is primarily a staging procedure most commonly used in prostate and bladder cancer. The role of lymphadenectomy has been well studied in patients with other types of malignancies and there is a consensus that the accuracy of the staging improves as more nodes are removed. The rationale for a staging PLND in prostate cancer is to accurately detect micrometastases in order to judge the need for adjuvant therapy. Currently, there is no consensus in the literature when considering the anatomical extent of the PLND. Several studies have shown that an extended PLND detects about twice as many nodes compared to a limited, restricted to the obturator fossa, dissection. PLND can be omitted in patients with low risk disease (Gleason score 6 or less, PSA greaterthan 10 ng/ml, cT1c) where the risk of having positive lymph node is less than 10%. For patients with greater risk of having metastasis we recommend an extended pelvic lymph node dissection (ePLND) which includes the nodes along the obturator fossa, the internal, external and common iliac arteries up to the crossing of the ureter. In bladder cancer the presence of lymph node metastases is on of the most important predictors of patient outcomes. There is evidence that a meticulous PLND at the time of radical cystectomy also can be curative in locally advanced disease. The advantages of robotic surgery (ten times magnification, EndoWrist© dexterity, 3-D view etc.) have allowed a transition from open to minimally invasive surgery, preserving the classical surgical technique. The most frequent complications related to PLND are lymphocele and lymph edema due to disruption of lymphatic vessels. Venous thrombotic events (VTE) and pulmonary embolism (PE) are potential complications associated with PLND. KeywordsProstate cancer-Bladder cancer-Pelvic lymph node dissection-Robotic prostatectomy-Robotic cystectomy
    12/2011: pages 391-396;
  • Magnus Annerstedt, Peter Wiklund
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    ABSTRACT: Radical cystectomy with pelvic lymph node dissection is the gold standard for treatment of localized invasive bladder cancer.1 - 3 The procedure is associated with a substantial morbidity and 25–50% of the patients will have complications in the perioperative period.4 - 6 The first laparoscopic cystectomy was performed in 19927 and several other centers have followed.8 Laparoscopic cystectomy has been reported in more than 500 patients and current results indicate that this minimally invasive approach may cause less blood loss, decreased postoperative pain, and faster recovery compared to open surgery.9,10 Due to the technical challenges of conventional laparoscopy (counterintuitive motion, two-dimensional laparoscopic vision, ergonomic drawback, and non-flexible instruments), leading to a steep learning curve and the lack of long-term oncological results, this approach has not gained a wide acceptance among urologists. KeywordsBladder cancer-Intracorporeal urinary diversion-Robotic cystectomy
    12/2011: pages 369-380;

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Institutions

  • 2011
    • University of Copenhagen Herlev Hospital
      Herlev, Capital Region, Denmark