Laparoscopic Para-aortic and Pelvic Lymphadenectomy: Experience with 150 Patients and Review of the Literature

Possover, Marc; Krause, Norman; Plaul, Karin; Kühne-Heid, R; Schneider, Achim

doi:10.1006/gyno.1998.5107

Cited by 173 publications

(79 citation statements)

References 34 publications

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“…25 After Childers et al reported the feasibility of laparoscopic surgical staging with acceptable morbidity and no delay of radiotherapy, 25 several investigators further performed laparoscopic surgical staging. [15][16][17] Laparoscopic surgical staging minimized intra-abdominal adhesions and decreases bowel morbidity. Smaller incisions in laparoscopy compared to laparotomy enabled short-term recovery and minimized immune suppression.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9] Transperitoneal and extraperitoneal abdominal approaches [10][11][12] After Laparoscopic LN staging was introduced in 1990, the feasibility, low morbidity and no delay of radiotherapy for such a procedure have been reported. [13][14][15][16][17] Laparoscopic LN staging was expected to maximize effect of radiotherapy by modifying radiotherapy field and by resection of bulky metastatic LN. 18 This study was conducted to investigate the feasibility, morbidity and treatment modification by pretreatment laparoscopic surgical staging in patients with locally advanced cervical cancer.…”

Section: Introductionmentioning

confidence: 99%

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Experiences of pretreatment laparoscopic surgical staging in patients with locally advanced cervical cancer: results of a prospective study

et al. 2008

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Objective: To prospectively evaluate the feasibility, safety, and survival of laparoscopic surgical staging in patients with locally advanced cervical cancer. Methods: From Oct 2001 to Jul 2006, a total of 83 consecutive patients were eligible for inclusion and underwent laparoscopic surgical staging. Results: Three patients with intraoperative great vessel injury and 1 patient in whom the colpotomizer was unable to be inserted were excluded. Laparoscopic surgical staging was feasible in 95.2% (79/83). Immediate postoperative complications were noted in 12 (15.2%) patients. Prolonged complications directly related to operative procedures numbered 2 (2.5%), and were trocar site metastases. The mean time from surgery to the start of radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) was 11 (5-35) days. All patients tolerated the treatment well and completed scheduled RT or CCRT without disruption of treatment and additional admission. The rate of modification of the radiation field after surgical staging was 8.9% (7/79). Five-year progression-free survival and overall survival (OS) rates were 79% and 89%, respectively. The OS of patients with microscopic lymph node metastases, which were fully resected, were comparable to those of patients without lymph node metastasis. However, the OS of patients with macroscopic lymph node metastases that were fully resected were poorer compared with those of patients without lymph node metastasis. Conclusion: Pretreatment laparoscopic surgical staging is a feasible and safe treatment modality. However the survival benefit of debulking lymph nodes or full lymph node dissection is not clear.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Experiences of pretreatment laparoscopic surgical staging in patients with locally advanced cervical cancer: results of a prospective study

et al. 2008

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“…7 The total laparoscopic hysterectomy has been described as potentially quicker, more efficient, and associated with less blood loss than either vaginal or abdominal surgeries and is also more achievable in nulliparous and obese women. 8,9 This study was conducted to compare the outcomes of total abdominal, vaginal and total laparoscopic hysterectomies performed at our hospital.…”

mentioning

confidence: 99%

Comparison of total abdominal, vaginal and total laparoscopic hysterectomy

Reddy

2016

Int Surg J

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“…Our technique of laparoscopic para-aortic and pelvic lymphadenectomy in women with cervical cancer was applied as described elsewhere [4]. During all these procedures, special attention was paid to the exposure of different pelvic nerves.…”

Section: Methodsmentioning

confidence: 99%

Laparoscopic exposure and electrostimulation of the somatic and autonomous pelvic nerves: a new method for implantation of neuroprothesis in paralyzed patients?

Possover

2004

Gynecol Surg

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Objective: The purpose of this study was to demonstrate the feasibility of the laparoscopic approach to expose the pelvic autonomous and somatic nerves for possible implantation of neuroprothesis for restoration of locomotion, micturition, defecation and ejaculation in paralyzed patients. Methods: In 146 patients undergoing laparoscopic para-aortic and pelvic lymphadenectomy for cervical cancer, sympathetic, parasympathetic and somatic nerves were precisely exposed in the para-aortic region and in the pelvis, which then allowed electrostimulation of the different nerves. In order to evaluate the motor activity of the stimulated nerves, transurethral and transrectal pressure catheters were employed. Results: Systematic laparoscopic exposure of all somatic and autonomous pelvic nerves was carried out in all 146 consecutive patients without any complications. Intraoperative neurostimulation demonstrated the exact function of the different exposed autonomic nerves. Conclusions: Selective laparoscopic implantation of neuroelectrodes to the somatic and autonomic pelvic nerves in a paralyzed patient may be a feasible and reproducible procedure for surgeons well-trained in laparoscopic surgery.

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Laparoscopic Para-aortic and Pelvic Lymphadenectomy: Experience with 150 Patients and Review of the Literature

Cited by 173 publications

References 34 publications

Experiences of pretreatment laparoscopic surgical staging in patients with locally advanced cervical cancer: results of a prospective study

Experiences of pretreatment laparoscopic surgical staging in patients with locally advanced cervical cancer: results of a prospective study

Comparison of total abdominal, vaginal and total laparoscopic hysterectomy

Laparoscopic exposure and electrostimulation of the somatic and autonomous pelvic nerves: a new method for implantation of neuroprothesis in paralyzed patients?

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