title: Role of different approaches to the abdominal retroperitoneum for aortic lymphadenectomy in patients with gynecological cancers.
abstract: BACKGROUND
  Paraaortic lymphadenectomy (PALN) is a standard part of many interventions, but currently there are no established care protocols effective in preventing gastro-intestinal (GI) symptoms. The aim of our study was to retrospectively evaluate patients with gynecologic cancers submitted to PALN, in order to evaluate if different approaches to the retroperitoneum could influence the radicality of the procedure and the onset of GI complications.
  
  
  METHODS
  We divided 121 patients with gynecologic tumors submitted to PALN into 3 groups according the used right, left or combined left-right approach to the retroperitoneum, comparing the groups according the main surgical-pathological parameters, such as the number of nodes removed and the incidence and severity of GI complications.
  
  
  RESULTS
  The mean number of nodes removed did not significantly differ between the groups, while the mean number of positive nodes was significantly higher in combined approach. 39.8% of our patients experienced GI side effects, but those submitted to the combined approach had a significantly higher incidence of GI symptoms.
  
  
  CONCLUSIONS
  Our data demonstrate that the choice of the retroperitoneal approach could be the most important feature for the appearance of post-operative GI side effects, even if there is no significant difference on the radicality of PALN performed retroperitoneal approach.
authors.affiliation: Department of Oncology, Catholic University, Campobasso, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ercoli
authors.forename: F
authors.initials: F
authors.lastname: Fanfani
authors.forename: M
authors.initials: M
authors.lastname: D'Asta
authors.forename: A
authors.initials: A
authors.lastname: Naldini
authors.forename: F
authors.initials: F
authors.lastname: Pacelli
authors.forename: G
authors.initials: G
authors.lastname: Scambia
authors.forename: A
authors.initials: A
authors.lastname: Fagotti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000379:methods*; D008875:Middle Aged; D012187:Retroperitoneal Space / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies