[Value of iliac direct-view retroperitoneoscopy (or "extraperitoneal pelvioscopy") in the assessment of lymph node invasion by pelvic cancer].
Iliac retroperitoneoscopy, also called extraperitoneal pelviscopy (EPP), is a form of direct vision endoscopy derived from mediastinoscopy; It allows biopsies of pelvic lymph nodes. In view of the poor accuracy of radiological investigations for pelvic lymph node metastasis (N+) detection, EPP was performed in 210 patients with apparently resectable neoplasms (bladder n = 116, prostate n = 81, cervix n = 12, endometrium n = 1). Among 174 patients without radiologic evidence of metastasis (N-), EPP assessed 47 N+ patients and failed in 1 case, requiring a laparotomy (one N+ patient). Among 36 N+ patients after radiologic examinations, EPP assessed 20 N- patients and failed in 1 case, requiring a laparotomy (one N+ patient). Among 124 N- patients after EPP, a further laparotomy showed 8 N+ cases (false negative). Thus, out of 210 patients, EPP corrected the radiologic findings in 67 cases and drastically modified the therapeutic indications. Considering its absence of contraindications, EPP can be performed more often than laparoscopic pelvic lymphadenectomy techniques. Furthermore, its exploration field is not limited to the interiliac area. Its overall reliability is 95% in staging lymph node involvement of pelvic neoplasms.
Wurtz
A
A
Clinique Chirurgicale Ouest, Secteur Hôpital Calmette, Lille.
Porte
H
H
Gambiez
L
L
Jaillard-Thery
S
S
Chambon
J P
JP
Mazeman
E
E
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D011859:Radiography; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy
Valeur de la rétropéritonéoscopie iliaque à vision directe (ou "pelvioscopie extrapéritonéale") dans le bilan d'extension ganglionnaire des cancers pelviens.