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Laparoscopic lymphadenectomy for gynecologic malignancies: evaluation of the surgical approach and outcomes over a seven-year experience

  • Gynecologic Oncology
  • Published:
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Abstract

Purpose

The purpose of this study was to evaluate the feasibility and efficacy of laparoscopic lymphadenectomy in patients with gynecologic malignancies and improve upon the existing published data regarding laparoscopic lymphadenectomy.

Methods

We conducted a retrospective chart review of 225 patients with various gynecologic malignancies who had undergone laparoscopic pelvic lymphadenectomy (LPL) and/or laparoscopic para-aortic lymphadenectomy (LPAL) at Kangbuk Samsung Hospital between November 2003 and October 2010.

Results

One hundred and seventy-two patients underwent both LPL and LPAL, 47 patients underwent LPL alone, and six patients underwent a repeat laparoscopic lymphadenectomy. The median age and body mass index of the patients were 49.4 years (range 23–79 years) and 24.2 kg/m2 (range 17.5–37.2 kg/m2). The median numbers of harvested pelvic and para-aortic lymph nodes were 25.9 (range 3–63) and 10.6 (range 1–34), respectively. The median operating times for the LPL and LPAL were 72.3 min (range 40–120 min) and 40 min (range 20–70 min), respectively. There were seven cases of major vessel injuries, two lymphocytes, two lymphedemas, and two chylous ascites. There was no unplanned conversion to laparotomy.

Conclusions

Laparoscopic lymphadenectomy can be considered a technically feasible and safe procedure and has become the alternative modality in the field of gynecologic oncology surgery. And our results could reinforce the existing published data regarding laparoscopic lymphadenectomy.

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References

  1. Querleu D, Leblanc E, Castelain B (1991) Laparoscopic pelvic lymphadenectomy in the staging of early carcinoma of the cervix. Am J Obstet Gynecol 164:579–581

    PubMed  CAS  Google Scholar 

  2. Nezhat C, Nezhat F, Burrell MO, Benigno B, Welander CE (1994) Laparoscopic radical hysterectomy with paraaortic and pelvic node dissection. Am J Obstet Gynecol 170:699

    PubMed  CAS  Google Scholar 

  3. Childers JM, Hatch K, Surwit EA (1992) The role of laparoscopic lymphadenectomy in the management of cervical carcinoma. Gynecol Oncol 47:38–43

    Article  PubMed  CAS  Google Scholar 

  4. Fowler JM, Carter JR, Carlson JW, Maslonkowski R, Byers LJ, Carson LF, Twiggs LB (1993) Lymph node yield from laparoscopic lymphadenectomy in cervical cancer: a comparative study. Gynecol Oncol 51:187–192

    Article  PubMed  CAS  Google Scholar 

  5. Childers JM, Brzechffa PR, Hatch KD, Surwit EA (1993) Laparoscopically assisted surgical staging (LASS) of endometrial cancer. Gynecol Oncol 51:33–38

    Article  PubMed  CAS  Google Scholar 

  6. Pomel C, Provencher D, Dauplat J, Gauthier P, Le Bouedec G, Drouin P, Audet-Lapointe P, Dubuc-Lissoir J (1995) Laparoscopic staging of early ovarian cancer. Gynecol Oncol 58:301–306

    Article  PubMed  CAS  Google Scholar 

  7. Lee JH, Jung US, Kyung MS, Choi JS (2008) Laparoscopic systemic retroperitoneal lymphadenenctomy for women with low-risk early endometrial cancer. Ann Acad Med Singap 38(7):581–586

    Google Scholar 

  8. ACOG practice bulletin (2005) Clinical management guidelines for obstetrician-gynecologists, number 65, August 2005 management of endometrial cancer. Obstet Gynecol 106:413–425

    Article  Google Scholar 

  9. Jung US, Lee JH, Kyung MS, Choi JS (2009) Feasibility and efficacy of laparoscopic management of ovarian cancer. J Obstet Gynaecol Res 35:113–118

    Article  PubMed  Google Scholar 

  10. Hoh JK, Choi JS, Lee JH, Lee KW, Han JS, Lee EJ (2009) Repeat laparoscopic paraaortic lymphadenectomy for an isolated lymph node recurrence in a patient with stage IB2 cervical cancer. J Minim Invasive Gynecol 16:781–784

    Article  PubMed  Google Scholar 

  11. Polyzos NP, Mauri D, Tsioras S, Messini CI, Valachis A, Messinis IE (2010) Intraperitoneal dissemination of endometrial cancer cells after hysteroscopy. Int J Gynecol Cancer 20:261–267

    Article  PubMed  Google Scholar 

  12. Choi JS, Kyung YS, Kim KH, Lee KW, Han JS (2006) The four-trocar method for performing laparoscopically assisted vaginal hysterectomy on large uteri. J Minim Invasive Gynecol 13:276–280

    Article  PubMed  Google Scholar 

  13. Possover M, Krause N, Plaul K, Kuhne-Heid R, Schneider A (1998) Laparoscopic para-aortic and pelvic lymphadenectomy: experience with 150 patients and review of the literature. Gynecol Oncol 71:19–28

    Article  PubMed  CAS  Google Scholar 

  14. Dottino PR, Tobias DH, Beddoe A, Golden AL, Cohen CJ (1999) Laparoscopic lymphadenectomy for gynecologic malignancies. Gynecol Oncol 73:383–388

    Article  PubMed  CAS  Google Scholar 

  15. Scribner DR Jr, Walker JL, Johnson GA, McMeekin SD, Gold MA, Mannel RS (2001) Laparoscopic pelvic and paraaortic lymph node dissection: analysis of the first 100 cases. Gynecol Oncol 82:498–503

    Article  PubMed  Google Scholar 

  16. Abu-Rustum NR, Chi DS, Sonoda Y, DiClemente MJ, Bekker G, Gemignani M, Poynor E, Brown C, Barakat RR (2003) Transperitoneal laparoscopic pelvic and para-aortic lymph node dissection using the argon-beam coagulator and monopolar instruments: an 8-year study and description of technique. Gynecol Oncol 89:504–513

    Article  PubMed  Google Scholar 

  17. Nezhat F, Yadav J, Rahaman J, Gretz H 3rd, Gardner GJ, Cohen CJ (2005) Laparoscopic lymphadenectomy for gynecologic malignancies using ultrasonically activated shears: analysis of first 100 cases. Gynecol Oncol 97:813–819

    Article  PubMed  Google Scholar 

  18. Lecuru F, Desfeux P, Camatte S, Bissery A, Blanc B, Querleu D (2006) Impact of initial surgical access on staging and survival of patients with stage I ovarian cancer. Int J Gynecol Cancer 16:87–94

    Article  PubMed  CAS  Google Scholar 

  19. Holub Z, Jabor A, Bartos P, Eim J, Urbanek S, Pivovarnikova R (2002) Laparoscopic surgery for endometrial cancer: long-term results of a multicentric study. Eur J Gynaecol Oncol 23:305–310

    PubMed  CAS  Google Scholar 

  20. Holub Z, Bartos P, Dorr A, Eim J, Jabor A, Kliment L Jr (1999) The role of laparoscopic hysterectomy and lymph node dissection in treatment of endometrial cancer. Eur J Gynaecol Oncol 20:268–271

    PubMed  CAS  Google Scholar 

  21. Eltabbakh GH, Shamonki MI, Moody JM, Garafano LL (2001) Laparoscopy as the primary modality for the treatment of women with endometrial carcinoma. Cancer 91:378–387

    Article  PubMed  CAS  Google Scholar 

  22. Scribner DR Jr, Walker JL, Johnson GA, McMeekin SD, Gold MA, Mannel RS (2001) Surgical management of early-stage endometrial cancer in the elderly: is laparoscopy feasible? Gynecol Oncol 83:563–568

    Article  PubMed  Google Scholar 

  23. Lecuru F, Taurelle R (1998) Transperitoneal laparoscopic pelvic lymphadenectomy for gynecologic malignancies (I). Tech results Surg Endosc 12:1–6

    CAS  Google Scholar 

  24. Jeong NH, Lee JM, Lee SK (2010) Current status in the management of uterine corpus cancer in Korea. J Gynecol oncol 21:151–162

    Article  PubMed  CAS  Google Scholar 

  25. Kohler C, Klemm P, Schau A, Possover M, Krause N, Tozzi R, Schneider A (2004) Introduction of transperitoneal lymphadenectomy in a gynecologic oncology center: analysis of 650 laparoscopic pelvic and/or paraaortic transperitoneal lymphadenectomies. Gynecol Oncol 95:52–61

    Article  PubMed  Google Scholar 

  26. Todo Y, Kato H, Kaneuchi M, Watari H, Takeda M, Sakuragi N (2010) Survival effect of para-aortic lymphadenectomy in endometrial cancer (SEPAL study): a retrospective cohort analysis. Lancet 375:1165–1172

    Article  PubMed  Google Scholar 

  27. Cragun JM, Havrilesky LJ, Calingaert B, Synan I, Secord AA, Soper JT, Clarke-Pearson DL, Berchuck A (2005) Retrospective analysis of selective lymphadenectomy in apparent early-stage endometrial cancer. J Clin Oncol 23:3668–3675

    Article  PubMed  Google Scholar 

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Correspondence to Joong Sub Choi.

Additional information

J. W. Bae and J. H. Lee contributed equally to this work.

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Bae, J.W., Lee, J.H., Choi, J.S. et al. Laparoscopic lymphadenectomy for gynecologic malignancies: evaluation of the surgical approach and outcomes over a seven-year experience. Arch Gynecol Obstet 285, 823–829 (2012). https://doi.org/10.1007/s00404-011-2056-x

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  • DOI: https://doi.org/10.1007/s00404-011-2056-x

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