TY - JOUR
T1 - Standardized technique of laparoscopic pelvic and para-aortic lymphadenectomy in gynecologic cancer optimizes the perioperative outcomes
AU - Kavallaris, Andreas
AU - Kalogiannidis, Ioannis
AU - Chalvatzas, Nektarios
AU - Hornemann, Amadeus
AU - Bohlmann, Michael K.
AU - Diedrich, Klaus
PY - 2011/6/1
Y1 - 2011/6/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=79956130467&partnerID=8YFLogxK
U2 - 10.1007/s00404-010-1580-4
DO - 10.1007/s00404-010-1580-4
M3 - Journal articles
C2 - 20607263
AN - SCOPUS:79956130467
SN - 0932-0067
VL - 283
SP - 1373
EP - 1380
JO - Archives of Gynecology and Obstetrics
JF - Archives of Gynecology and Obstetrics
IS - 6
ER -