Laparoscopic para-aortic lymphadenectomy in gynecologic malignancies

Joel M. Childers, Kenneth D Hatch, Ai Nhi Tran, Earl A. Surwit

Research output: Contribution to journalArticle

172 Citations (Scopus)

Abstract

Objective: To determine the feasibility, safety, limiting factors, and advantages of laparoscopic para-aortic lymphadenectomy in a series of patients with gynecologic malignancies. Methods: During a 2-year period, 61 women underwent laparoscopic para-aortic lymph node dissection as part of their management for invasive gynecologic malignancies. A transperitoneal incision directly over the aorta was used. Initially, only the right-side infra-inferior mesenteric artery nodes were removed. The technique of removal of left-side low para-aortic nodes was then developed, followed by the technique for removal of right-and left-side nodes above the transverse duodenum. A total of 52 right para-aortic lymph-adenectomies were performed, 12 of which were combined with left-side lymphadenectomies. A total of 17 left-side lymphadenectomies were performed, 12 of which were bilateral. Four patients had nodes removed above the inferior mesenteric artery. Results: The procedure could not be performed in four instances because of obesity or adhesions. Twenty-four patients had their laparoscopic surgery combined with another procedure, which increased their hospital stays: radical hysterectomy (five), laparoscopy-assisted vaginal hysterectomy (17), transperineal interstitial irradiation (one), and anterior-posterior colporrhaphy (one). The remaining 33 patients had laparoscopic surgical staging only. One patient required laparotomy to control bleeding from the vena cava; however, the others had no short-or long-term complications, and the average hospital stay was 1.3 days. Conclusion: Laparoscopic para-aortic lymphadenectomy is a safe, effective procedure that allows a shorter hospitalization than traditional laparotomy. (Obstet Gynecol 1993; 82:741-7).

Original languageEnglish (US)
Pages (from-to)741-747
Number of pages7
JournalObstetrics and Gynecology
Volume82
Issue number5
StatePublished - 1993
Externally publishedYes

Fingerprint

Lymph Node Excision
Inferior Mesenteric Artery
Neoplasms
Laparoscopy
Laparotomy
Length of Stay
Vaginal Hysterectomy
Venae Cavae
Lymph
Hysterectomy
Duodenum
Aorta
Hospitalization
Obesity
Hemorrhage
Safety

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Childers, J. M., Hatch, K. D., Tran, A. N., & Surwit, E. A. (1993). Laparoscopic para-aortic lymphadenectomy in gynecologic malignancies. Obstetrics and Gynecology, 82(5), 741-747.

Laparoscopic para-aortic lymphadenectomy in gynecologic malignancies. / Childers, Joel M.; Hatch, Kenneth D; Tran, Ai Nhi; Surwit, Earl A.

In: Obstetrics and Gynecology, Vol. 82, No. 5, 1993, p. 741-747.

Research output: Contribution to journalArticle

Childers, JM, Hatch, KD, Tran, AN & Surwit, EA 1993, 'Laparoscopic para-aortic lymphadenectomy in gynecologic malignancies', Obstetrics and Gynecology, vol. 82, no. 5, pp. 741-747.
Childers, Joel M. ; Hatch, Kenneth D ; Tran, Ai Nhi ; Surwit, Earl A. / Laparoscopic para-aortic lymphadenectomy in gynecologic malignancies. In: Obstetrics and Gynecology. 1993 ; Vol. 82, No. 5. pp. 741-747.
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