Usefulness of extraperitoneal laparoscopic paraaortic lymphadenectomy for lymph node recurrence in gynecologic malignancy.
OBJECTIVE
The aim of this study was to evaluate the safety and feasibility of extraperitoneal laparoscopic paraaortic lymphadenectomy for suspected lymph node recurrence of gynecological cancers.


METHODS
Descriptive study.


METHODS
Unit of Gynecologic Oncology of an acute-care teaching hospital in Barcelona, Spain.


METHODS
Between December 2002 and October 2007, eight women underwent extraperitoneal laparoscopic paraaortic lymphadenectomy for suspected lymph node recurrence, detected by magnetic resonance image (MRI), computed tomography (CT) scan or 18F-fluorodeoxyglucose positron emission tomography (PET) scanning. The suspicious nodes were removed through an extraperitoneal laparoscopic approach.


RESULTS
The median age of patients was 66.5 years (range: 54-74). The median operating time was 157.5 minutes (range: 120-240). The median blood loss was 112.5 mL (range: 50-150). The mean nodal yield was 9.4+/-4.72 (range: 1-16). There were no intraoperative or postoperative complications. The median hospital stay was two days. Histological examination revealed metastasis in seven of eight patients.


CONCLUSIONS
The extraperitoneal laparoscopic paraaortic lymphadenectomy for lymph node recurrence of gynecological cancers is a safe and feasible procedure which should be considered where there is isolated involvement of retroperitoneal lymph nodes. This procedure is a minimally invasive technique that allows an excellent approach to the paraaortic lymph nodes.
Gil-Moreno
Antonio
A
Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-infantil Vall d'Hebron, Barcelona, Spain. agil@vhebron.net
Franco-Camps
Silvia
S
Díaz-Feijoo
Berta
B
Pérez-Benavente
Asumpció
A
Martínez-Palones
José M
JM
Del Campo
José M
JM
Parera
Marta
M
Verges
Ramona
R
Castellví
Josep
J
Xercavins
Jordi
J
D000368:Aged; D001012:Aorta, Abdominal; D003952:Diagnostic Imaging; D005240:Feasibility Studies; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology*; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery