Comparison Between Transperitoneal and Extraperitoneal Laparoscopic Paraaortic Lymphadenectomy in Gynecologic Malignancies

Akladios, Chérif; Ronzino, Valentine; Schrot-Sanyan, Stéphanie; Afors, Karolina; Fernandes, Rodrigo; Jj, Baldauf; Wattiez, Arnaud

doi:10.1016/j.jmig.2014.10.011

Cited by 22 publications

(20 citation statements)

References 20 publications

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“…This allows for relatively rapid access to vascular axes, in particular to the left aortic group of lymph nodes until the level of the renal vein, without being restricted by bowel loops [41,42]. This makes the extra-peritoneal approach particularly suitable in obese patients where exposure of major retroperitoneal vessels in a trans-peritoneal laparoscopy can be a major issue [42]. Previous studies investigating the use of laparoscopic trans-peritoneal PAL for patients with endometrial cancer have identified obesity as a potential shortcoming of this approach.…”

Section: Surgical Management Of Malignancy In Obese Womenmentioning

confidence: 99%

Obesity in laparoscopic surgery

Afors

Centini

Murtada

et al. 2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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Section: Surgical Management Of Malignancy In Obese Womenmentioning

confidence: 99%

Obesity in laparoscopic surgery

Afors

Centini

Murtada

et al. 2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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“…With regard to the surgical approach for dissecting PALN metastases from CRC, open surgery was initially indicated, but the surgical complication rate ranged from 25% to 50% . Recently, laparoscopic para‐aortic lymphadenectomy for metastases from gynecological and retroperitoneal malignancies has demonstrated favorable surgical outcomes . However, there have been few reports about laparoscopic para‐aortic lymphadenectomy for metastases from CRC .…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic para‐aortic lymphadenectomy for colorectal cancer with clinically suspected lymph node metastasis

Yamamoto

Kanai

et al. 2018

Asian J Endoscop Surgery

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Introduction The optimal surgical management strategy for isolated para‐aortic lymph node (PALN) metastases from colorectal cancer (CRC) remains unclear. However, the complication rates for open approaches remain high. In this study, the outcomes of laparoscopic para‐aortic lymphadenectomy in patients with clinically suspected PALN metastasis were evaluated. Methods Between April 2013 and April 2018, we performed laparoscopic primary resection and para‐aortic lymphadenectomy in 11 patients with advanced colorectal cancer and clinically suspected PALN metastasis. This study was a single‐center, retrospective, case series analysis, and the surgical outcomes were reviewed. Results There were no cases of perioperative mortality, and conversion to open surgery was necessary in only one patient (9%) because of invasion into a rib. One patient (9%) required a blood transfusion. Postoperative complications occurred in three patients, and the morbidity rate was 27% (3/11). Pathologically, PALN metastasis was confirmed in five patients (45%), all of whom received postoperative chemotherapy. The median survival time for all patients was 25 months, and one patient died of recurrence at 25 months after the initial surgery. Two other patients were alive with recurrence after 47 and 36 months, and two patients were alive without recurrence after 17 and 2 months. Conclusion Laparoscopic para‐aortic lymphadenectomy for advanced colorectal cancer with clinically suspected PALN is technically feasible and may be beneficial in selected patients. It is necessary to investigate the feasibility of this procedure in a future case series, and information regarding true oncologic outcome will require long‐term follow‐up.

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“…The main characteristics of robotic technology that facilitate surgical performances also help to shorten the learning curve, including three‐dimensional visualization, articulated instrumentation, and stability of the camera . In addition, further technological improvements have improved the versatility of its use, and robotic‐assisted laparoscopy is now a valid and diffused surgical method for treatment of gynecological cancers, even when para‐aortic lymphadenectomy is required …”

Section: Introductionmentioning

confidence: 99%

“…19 In addition, further technological improvements have improved the versatility of its use, and robotic-assisted laparoscopy is now a valid and diffused surgical method for treatment of gynecological cancers, even when para-aortic lymphadenectomy is required. [20][21][22][23][24][25][26][27][28][29][30] In this context, we investigated the surgical outcome of the robotic approach in gynecological cancer patients undergoing pelvic surgery and aortic lymphadenectomy. All patients provided a written informed consent for their data to be collected and analyzed for scientific purpose, according to our institutional policy.…”

mentioning

confidence: 99%

The role of robotic aortic lymphadenectomy in gynecological cancer: surgical and oncological outcome in a single institution experience

Gallotta

Federico

Gaballa

et al. 2018

Journal of Surgical Oncology

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Background and Objective This study aims to investigate the surgical outcomes observed in robotic transperitoneal aortic lymphadenectomy (AL) in gynecological cancer patients. Methods Retrospective data were collected and analyzed on 71 patients undergoing robotic surgical procedures for gynecological cancers, including transperitoneal AL, between December 2014 and February 2018 at the Catholic University of the Sacred Heart, Rome, Italy. Results Median age of the sample population was 50 years (range, 26‐76 years). The median operative time was 210 minutes (range, 75‐480 minutes), the median estimated blood loss was 50 ml (range, 20‐300 ml). The number of para‐aortic nodes removed was 12 (range, 7‐43). In the whole series, 13 patients (18.3%) had at least one metastatic node. Overall, 10 patients (14.1%) experienced any grade early postoperative complications. Three patients experienced more than one complication. Three intraoperative complications occurred with two cases of vascular injury. Conversion to laparotomy was necessary for one patient (1.4%). Conclusions The present study shows the safety and adequacy of robotic transperitoneal AL as surgical staging step for gynecological cancers in terms of perioperative and postoperative outcomes.

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Comparison Between Transperitoneal and Extraperitoneal Laparoscopic Paraaortic Lymphadenectomy in Gynecologic Malignancies

Cited by 22 publications

References 20 publications

Obesity in laparoscopic surgery

Obesity in laparoscopic surgery

Laparoscopic para‐aortic lymphadenectomy for colorectal cancer with clinically suspected lymph node metastasis

The role of robotic aortic lymphadenectomy in gynecological cancer: surgical and oncological outcome in a single institution experience

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