title: Extraperitoneal laparoscopic lymph node staging: the University of Southern California experience.
abstract: OBJECTIVE
  To describe our experience with extraperitoneal lymph node staging in gynecologic oncology.
  
  
  METHODS
  The extraperitoneal approach was performed to assess the lymph node histology in patients with gynecologic malignancies. The nodes are approached from a lateral approach after dissecting open the extraperitoneal space bluntly and with insufflation. Bilateral aortic nodes are taken from a left-sided or right-sided approach depending on the patient's characteristics.
  
  
  RESULTS
  Forty-six patients underwent this procedure over a 2.5-year period. Thirty-seven patients had cervical cancer. The median BMI was 27.1 (17.7-38.1). The median lymph node yield was 14 (0-60). Two patients had disruption of the peritoneum such that the aortic lymphadenectomy had to be completed transperitoneally. No patients required laparotomy. No patients required transfusion.
  
  
  CONCLUSIONS
  This technique permits histologic evaluation of the retroperitoneal nodes with minimal risk of intraabdominal adhesions. Recovery is rapid and further therapy can be prescribed shortly. The data on the nodes can assist in treatment planning.
authors.affiliation: Division of Gynecologic Oncology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. aburnett@uams.edu
authors.forename: Alexander F
authors.initials: AF
authors.lastname: Burnett
authors.forename: Anne T
authors.initials: AT
authors.lastname: O'Meara
authors.forename: Afshin
authors.initials: A
authors.lastname: Bahador
authors.forename: Lynda D
authors.initials: LD
authors.lastname: Roman
authors.forename: C Paul
authors.initials: CP
authors.lastname: Morrow
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004503:Education, Medical, Graduate; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology*; D006176:Gynecology / Q000193:education / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008495:Medical Oncology / Q000193:education / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D012187:Retroperitoneal Space