title: Paraaortic lymph node sampling by means of an extraperitoneal approach with a supraumbilical transverse "sunrise" incision.
abstract: OBJECTIVE
  Extraperitoneal approaches to removal of lymph nodes for staging in cervical cancer patients are numerous, and each has disadvantages. We developed a supraumbilical transverse incision to initiate irradiation within days of cervical cancer staging.
  
  
  METHODS
  Twenty patients with advanced stage IIB or IIIB cervical cancer underwent surgical staging with a supraumbilical incision during the time period Jan. 1, 1988, to Aug. 1, 1992. The incisions were made 6 cm above the umbilicus and carried laterally in a caudad manner to the iliac crests. All nodes were removed in an extraperitoneal fashion.
  
  
  RESULTS
  In the 20 patients who were operated on, the mean number of nodes removed was 9.8. Estimated blood loss ranged from 50 to 300 ml. The procedure time ranged from 50 to 150 minutes. All patients but two had irradiation initiated within 2 weeks of the procedure. Complications included an identified and repaired ureteral injury, a prolonged ileus, and a small bowel obstruction.
  
  
  CONCLUSIONS
  An extraperitoneal approach with the "sunrise" incision allows irradiation to begin within days of surgery. The operating time is relatively short. The incision can be extended caudally and extraperitoneally if needed for removal of bulky pelvic nodes.
authors.affiliation: Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta 30912.
authors.forename: D G
authors.initials: DG
authors.lastname: Gallup
authors.forename: L A
authors.initials: LA
authors.lastname: King
authors.forename: M J
authors.initials: MJ
authors.lastname: Messing
authors.forename: O E
authors.initials: OE
authors.lastname: Talledo
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery