Prospective Randomized Trial Comparing Transperitoneal Versus Extraperitoneal Laparoscopic Aortic Lymphadenectomy for Surgical Staging of Endometrial and Ovarian Cancer: The STELLA Trial

Abstract

The STELLA trial is registered at the US National Institutes of Health (ClinicalTrials.gov) #NCT01810874.

Simple radiologic assessment of visceral obesity and prediction of surgical morbidity in high-risk endometrial cancer: a reliability and accuracy pilot study

“…We observed an intraoperative complication rate of 10.3% and an early postoperative complication rate of 26.5%. We found a higher rate of surgical morbidity in the conventional vs. robotic-assisted laparoscopy subgroup, findings that are consistent with previously reported results 4,5,24,42 .…”

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

“…Recently, a prospective randomized multicenter study (STELLA Trial) concluded that extraperitoneal and transperitoneal approaches to laparoscopic and robotic AL provide similar perioperative outcomes and lymph node yields. 34 The authors of this study also concluded that factors to be taken into account for choosing between extraperitoneal versus transperitoneal approach primarily include patient habitus, site of lymph node disease, and type of procedures required for completion of surgery.…”

“…Different techniques have been described for robotic AL, to improve surgical outcome, even in challenging situations including patients with: obesity, presence of lymph nodes metastases, necessity to remove infrarenal aortic nodes up to the renal vein; presence of anatomical variations of vessels in the aortic area; and history of previous surgery or neoadjuvant treatments. Recently, a prospective randomized multicenter study (STELLA Trial) concluded that extraperitoneal and transperitoneal approaches to laparoscopic and robotic AL provide similar perioperative outcomes and lymph node yields . The authors of this study also concluded that factors to be taken into account for choosing between extraperitoneal versus transperitoneal approach primarily include patient habitus, site of lymph node disease, and type of procedures required for completion of surgery.…”

“…To our knowledge, this represents one of the largest series analyzing surgical outcomes and postoperative morbidity of robotic transperitoneal surgery for staging in gynecological cancer patients undergoing aortic lymphadenectomy 25,28,29,[32][33][34][35][36][37] (Table 5). Systematic aortic lymphadenectomy was performed in all cases using a single-docking approach.…”

Transperitoneal Versus Extraperitoneal Laparoscopic Lymphadenectomy for Gynecological Malignancies: A Systematic Review and Meta-analysis

“…Included studies. A total of seven studies, one randomized control trial and six retrospective trials, which included 608 patients who underwent para-aortic TLL versus ELL, were finally included in the present systematic review (13)(14)(15)(16)(17)(18)(19). Among them, 329 patients underwent TLL, while the remaining 279 patients comprised the ELL group.…”