Abstract
Objective: Locally advanced cervical cancers are generally managed by radiation and chemotherapy. Pretherapeutic laparoscopic assessment of aortic nodes in patients with locally advanced cervical cancer offers valuable information for individualized treatment planning with minimal morbidity when the extraperitoneal approach is used. Although the pioneers of the technique proposed to sample only the aortic and common iliac nodes, there is growing evidence that concomitant radiation and chemotherapy does not control all the diseased pelvic nodes. As a result, diseased but not fixed pelvic nodes amenable to an attempt at laparoscopic removal should be debulked during the staging surgery. The objective of this paper is to describe a new development of the extraperitoneal endosurgical approach. Methods: The left extraperitoneal approach routinely used for aortic and common iliac dissection has been extended to the pelvic area in eight patients. Results: The left pelvic dissection, including the removal of obturator nodes, has been successfully completed in all cases, including two patients with macroscopically diseased nodes. The right pelvic dissection has been successful in three out of four attempts. Conclusion: The lateral extraperitoneal route used for the routine staging in our institution can be extended to the pelvic area without additional transumbilical transperitoneal laparoscopy, thus reducing the adhesion formation in patients candidates for definitive radiation therapy.
| Original language | English |
|---|---|
| Pages (from-to) | 81-85 |
| Number of pages | 5 |
| Journal | Gynecologic Oncology |
| Volume | 109 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Apr 2008 |
| Externally published | Yes |
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Keywords
- Cervical cancer
- Extraperitoneal dissection
- Lymphadenectomy
- Staging
ASJC Scopus subject areas
- Obstetrics and Gynaecology
- Oncology
Cite this
Pelvic lymph node dissection via a lateral extraperitoneal approach : Description of a technique. / Querleu, Denis; Ferron, Gwenael; Tabrizi, Arash Rafii; Bouissou, Emilie; Delannes, Martine; Mery, Eliane; Gladieff, Laurence.
In: Gynecologic Oncology, Vol. 109, No. 1, 04.2008, p. 81-85.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Pelvic lymph node dissection via a lateral extraperitoneal approach
T2 - Description of a technique
AU - Querleu, Denis
AU - Ferron, Gwenael
AU - Tabrizi, Arash Rafii
AU - Bouissou, Emilie
AU - Delannes, Martine
AU - Mery, Eliane
AU - Gladieff, Laurence
PY - 2008/4
Y1 - 2008/4
N2 - Objective: Locally advanced cervical cancers are generally managed by radiation and chemotherapy. Pretherapeutic laparoscopic assessment of aortic nodes in patients with locally advanced cervical cancer offers valuable information for individualized treatment planning with minimal morbidity when the extraperitoneal approach is used. Although the pioneers of the technique proposed to sample only the aortic and common iliac nodes, there is growing evidence that concomitant radiation and chemotherapy does not control all the diseased pelvic nodes. As a result, diseased but not fixed pelvic nodes amenable to an attempt at laparoscopic removal should be debulked during the staging surgery. The objective of this paper is to describe a new development of the extraperitoneal endosurgical approach. Methods: The left extraperitoneal approach routinely used for aortic and common iliac dissection has been extended to the pelvic area in eight patients. Results: The left pelvic dissection, including the removal of obturator nodes, has been successfully completed in all cases, including two patients with macroscopically diseased nodes. The right pelvic dissection has been successful in three out of four attempts. Conclusion: The lateral extraperitoneal route used for the routine staging in our institution can be extended to the pelvic area without additional transumbilical transperitoneal laparoscopy, thus reducing the adhesion formation in patients candidates for definitive radiation therapy.
AB - Objective: Locally advanced cervical cancers are generally managed by radiation and chemotherapy. Pretherapeutic laparoscopic assessment of aortic nodes in patients with locally advanced cervical cancer offers valuable information for individualized treatment planning with minimal morbidity when the extraperitoneal approach is used. Although the pioneers of the technique proposed to sample only the aortic and common iliac nodes, there is growing evidence that concomitant radiation and chemotherapy does not control all the diseased pelvic nodes. As a result, diseased but not fixed pelvic nodes amenable to an attempt at laparoscopic removal should be debulked during the staging surgery. The objective of this paper is to describe a new development of the extraperitoneal endosurgical approach. Methods: The left extraperitoneal approach routinely used for aortic and common iliac dissection has been extended to the pelvic area in eight patients. Results: The left pelvic dissection, including the removal of obturator nodes, has been successfully completed in all cases, including two patients with macroscopically diseased nodes. The right pelvic dissection has been successful in three out of four attempts. Conclusion: The lateral extraperitoneal route used for the routine staging in our institution can be extended to the pelvic area without additional transumbilical transperitoneal laparoscopy, thus reducing the adhesion formation in patients candidates for definitive radiation therapy.
KW - Cervical cancer
KW - Extraperitoneal dissection
KW - Lymphadenectomy
KW - Staging
UR - http://www.scopus.com/inward/record.url?scp=40949135040&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=40949135040&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2007.12.031
DO - 10.1016/j.ygyno.2007.12.031
M3 - Article
C2 - 18258287
AN - SCOPUS:40949135040
VL - 109
SP - 81
EP - 85
JO - Gynecologic Oncology
JF - Gynecologic Oncology
SN - 0090-8258
IS - 1
ER -