title: Transperitoneal laparoscopical iliac lymphadenectomy for treatment of malignant melanoma.
abstract: BACKGROUND
  Current treatment for melanoma of the lower limb includes excision of the primary tumor with ilioinguinal lymphadenectomy in the case of lymph node metastases. The standard surgical approach includes sectioning of the inguinal ligament to gain access to the iliac nodes. More recently, some authors have reported that extraperitoneal laparoscopically assisted ilioinguinal lymphadenectomy for the treatment of malignant melanoma is feasible and less aggressive than standard open surgery. So far, no publications have described transperitoneal laparoscopic iliac lymphadenectomy (TPLND).
  
  
  METHODS
  From November 2001 to June 2002, 13 patients with ilioinguinal node melanoma metastases underwent TPLND (stage IIIA in 1 case, IIIB in 5 cases, IIIC in 4 cases, and IV in 3 cases).
  
  
  RESULTS
  In all 13 cases, the TPLND and groin dissection was performed correctly. Operative time, intra- and postoperative complications, number of lymph nodes retrieved, immediate morbidity, hospital stay, and feasibility of TPLND were evaluated.
  
  
  CONCLUSIONS
  This study was conducted to evaluate the feasibility and the preliminary results of TPLND used to manage malignant melanoma of the lower limb. This approach has many advantages over the traditional procedure: less surgical trauma, no incision of the abdominal muscles or the inguinal ligament, and less postoperative pain. Moreover, as compared with extraperitoneal laparoscopically assisted ilioinguinal lymphoadenectomy, it provides an improved view of the operative area, dissection zone, and surrounding structures. Further research is needed to confirm these preliminary results regarding the potential applications of this method for treating malignant metastasis to the lower limb.
authors.affiliation: Operative Unit of Surgical Dermatology, Institute for Cancer Research and Treatment, Strada Provinciale 142, Km 3.95, 10060 Candiolo, Italy. fpicciotto@mauriziano.it
authors.forename: F
authors.initials: F
authors.lastname: Picciotto
authors.forename: E
authors.initials: E
authors.lastname: Volpi
authors.forename: A
authors.initials: A
authors.lastname: Zaccagna
authors.forename: D
authors.initials: D
authors.lastname: Siatis
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006119:Groin / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007866:Leg; D007902:Length of Stay; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged; D009367:Neoplasm Staging; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*