title: [Laparoscopic lymph-node dissection in gynecological surgery].
abstract: OBJECTIVE
  To analyze our experience with transperitoneal laparoscopic dissection of lymphatic nodes in women with gynecologic malignancies.
  
  
  METHODS
  Retrospective clinical study.
  
  
  METHODS
  Center of gynecologic endoscopy and minimally invasive surgery; Department of Obstetrics and Gynecology, General Faculty Hospital and 1st Medical Faculty in Prague.
  
  
  METHODS
  Analysis of data from our laparoscopic procedures in the years 2006-2011. The following procedures have been included: systematic pelvic lymphadenectomy (PLN), paraaortic lymphadenectomy (PALN), pelvic sentinel node excision, focused dissection of bulky lymphatic nodes from pelvis or paraaortic area.
  
  
  RESULTS
  We performed 177 primarily laparoscopic procedures pointed at dissection of pelvic and/or paraaortic lymph-nodes. The mean operating time and the mean number of lymph-nodes was 82 minutes and 26.5 nodes in patients with PLN, and 75 minutes and 12.5 nodes in patients with PALN. The overall rate of laparo-conversions was 4.5%; the incidence of major complications was 6.8% and of serious bleeding 5.6%. Laparoscopic lymphadenectomy could not be performed or completed in 2.3% of cases. Complications were more frequently associated with PALN than with PLN.
  
  
  CONCLUSIONS
  Laparoscopic approach to PLN and PALN is feasible in vast majority of patients. It provides adequate earnings of the lymphatic nodes, tolerable operative time, and relatively low complication rate. The highly experienced operation team for especially high infrarenal PALN is necessary.
authors.affiliation: Gynekologicko-porodnicka klinika, Praha. michal.mara@quick.cz
authors.forename: M
authors.initials: M
authors.lastname: Mára
authors.forename: M
authors.initials: M
authors.lastname: Fanta
authors.forename: J
authors.initials: J
authors.lastname: Sláma
authors.forename: M
authors.initials: M
authors.lastname: Zikán
authors.forename: K
authors.initials: K
authors.lastname: Kubínová
authors.forename: D
authors.initials: D
authors.lastname: Kužel
authors.forename: D
authors.initials: D
authors.lastname: Cibula
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta; D061887:Conversion to Open Surgery; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D010388:Pelvis; D055815:Young Adult