Laparoscopic para-aortic lymphadenectomy in gynecologic malignancies

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

Research output: Contribution to journalArticle

177 Scopus citations

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 - Nov 1993
Externally publishedYes

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    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.