Standardized technique of laparoscopic pelvic and para-aortic lymphadenectomy in gynecologic cancer optimizes the perioperative outcomes. Kavallaris A, Kalogiannidis I, Chalvatzas N, Hornemann A, Bohlmann MK, Diedrich K. Arch Gynecol Obstet. 2010 Jul 6.

Title:

Description:

Standardized technique of laparoscopic pelvic and para-aortic lymphadenectomy in gynecologic cancer optimizes the perioperative outcomes. Kavallaris A, Kalogiannidis I, Chalvatzas N, Hornemann A, Bohlmann MK, Diedrich K. Arch Gynecol Obstet. 2010 Jul 6.

Abstract
INTRODUCTION: The main objective of this study is to illustrate the
effectiveness and the safety of standardized technique of
laparoscopic lymphadenectomy (LNE), newly introduced in a
University Hospital, in patients with gynecologic malignancy.
MATERIALS AND METHODS: A cohort of 104 patients with gynaecologic
malignancies (71 with endometrial and 33 with cervical cancer), who
underwent laparoscopic pelvic with or without para-aortic LNE
between September 2008 and March 2010, were analyzed. Total
laparoscopic hysterectomy with bilateral salpingo-oophorectomy (TLH
& BSO) was the standard approach for patients with endometrial
cancer (n = 71), while laparoscopic (nerve sparing) radical
hysterectomy (n = 29), laparoscopic-assisted radical vaginal
hysterectomy (n = 2) and radical trachelectomy was the treatment
for patients with cervical cancer. All LNE were performed by a
learning team under the supervision of an expert surgeon, familiar
with the technique.
RESULTS: The median number of pelvic lymph nodes yielded was 22
(range 16-34) and of para-aortic 14 (range 12-24). The mean
operative time ± standard deviation for pelvic LNE for each side
was 29 ± 17 and 64 ± 29 min for para-aortic LNE. The overall
complication rate was 7.6% (n = 8). Two patients were reoperated
laparoscopically, one because of postoperative hemorrhage and the
other because of lymphocyst formation; laparoconversion was not
necessary.
DISCUSSION: Laparoscopic lymphadenectomy performed by a learning
team with standardized technique is effective with adequate number
of harvested nodes, in acceptable operative time and with low rate
of perioperative complications.
PMID: 20607263 [PubMed – indexed for MEDLINE]

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