The perioperative morbidity of laparoscopic pelvic lymph node staging in patients with advanced cervical cancer.
BACKGROUND
Laparoscopic pelvic lymph node staging is widely used in patients with cervical cancer prior to the initiation of primary chemoradiation therapy. Data on the morbidity of this procedure are sparse.


METHODS
Between 1995 and 2007, 71 patients with locally advanced cervical cancer (FIGO stage IB2-IIIB) underwent laparoscopic pelvic lymph node staging prior to primary chemoradiation therapy. Surgical outcome and perioperative morbidity were evaluated.


RESULTS
The median operation time, number of resected lymph nodes and time between surgery and the initiation of chemoradiation therapy was 100 minutes, 15 lymph nodes and 18 days, respectively. Intraoperatively, one laceration of the obturatoric artery and one bladder injury occurred. One procedure was converted to a laparotomy. Three short-term postoperative complications including one hematoma in the port side area, one umbilical suture insufficiency requiring a hernia reposition, and one postoperative bleeding that required rehospitalization were noted. Two patients with intraabdominal abscesses required repeat laparoscopy. Of note, three patients developed port site metastases during followup.


CONCLUSIONS
Although patients experienced perioperative morbidity, the present study provides further evidence that, overall, laparoscopic pelvic lymph node staging is a relatively safe procedure for patients with cervical cancer.
Polterauer
Stephan
S
Department of Obstetrics and Gynecology, Medical University of Vienna, Austria.
Hefler
Lukas A
LA
Petry
Maiva
M
Seebacher
Veronika
V
Tempfer
Clemens
C
Reinthaller
Alexander
A
D005260:Female; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery*; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery*