Laparoscopic extraperitoneal paraaortic lymphadenectomy: a study of its applications in gynecological malignancies

Mehra, Gautam; Weekes, A. R. L.; Jacobs, Ian; Visvanathan, Dilip; Menon, Usha; Jeyarajah, Arjun

doi:10.1016/j.ygyno.2003.12.035

Cited by 52 publications

(38 citation statements)

References 16 publications

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“…Our operative time and intraoperative blood losses are comparable to what is published from other researchers who used either electrocautery or Ultracision technology [15][16][17][18]. As expected, the operative time decreased as we became more familiar with the use of the instrument (Fig.…”

Section: Discussionsupporting

confidence: 83%

The use of harmonic shears (Ultracision) for laparoscopic lymphadenectomies in women with gynaecological malignancies

et al. 2005

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The purpose of this paper is to evaluate the safety and efficacy of the harmonic scalpel for laparoscopic pelvic and para-aortic lymphadenectomy in the management of gynaecologic cancers. A prospective study of 21 consecutive patients with gynaecologic cancer, including cervical (11), endometrial (3), ovarian (6) and tubal (1). Eleven patients had pelvic nodes retrieval only, two had para-aortic nodes retrieval only and eight had both. Eighteen patients had transperitoneal lymphadenectomies, one had extraperitoneal and two had both. Eleven patients had a hysterectomy or salpingooophorectomy in addition to the laparoscopic lymphadenectomy. In all cases, the harmonic scalpel was used as the only instrument to achieve haemostasis. Average nodal yields were 21.4 for bilateral pelvic lymphadenectomies. The mean estimated blood loss was 132.7 ml. There were no intraoperative complications. Laparoscopic pelvic and para-aortic lymphadenectomy using the harmonic scalpel appears to be both safe and efficient in the management of patients with gynaecologic cancers. Its main advantage is that it enables simultaneous and safe tissue dissection, haemostasis and cutting, avoiding the exchange of several instruments. It could become the first choice instrument for this procedure.

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Section: Discussionsupporting

confidence: 83%

The use of harmonic shears (Ultracision) for laparoscopic lymphadenectomies in women with gynaecological malignancies

et al. 2005

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“…Mehra et al [39] found that this approach identifies those cervical and endometrial cancers requiring extendedfield radiation as part of their adjuvant therapy and can be used efficaciously in staging early ovarian cancers to determine the need for adjuvant chemotherapy.…”

Section: Laparoscopic Extraperitoneal Lymphadenectomymentioning

confidence: 99%

Role of Minimally Invasive Surgery in Gynecologic Cancers

Schlaerth

Abu‐Rustum

2006

The Oncologist

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The role of minimally invasive surgery in the management of gynecologic cancers continues to expand. Radical vaginal trachelectomy with laparoscopic pelvic lymphadenectomy has emerged as a safe, reasonable option for women with early-stage cervical cancer desiring fertility preservation. Similarly, laparoscopically assisted radical vaginal hysterectomy has been systematically described, is feasible, and can be offered to women with early-stage cervical cancer who do not desire future childbearing. In the treatment of earlystage endometrial cancer, the surgical approach of laparoscopic hysterectomy, peritoneal washings, and pelvic and para-aortic lymph node dissection, with or without an omentectomy, is being compared with the same surgery performed via laparotomy in the cooperative Gynecologic Oncology Group LAP 2 study, which has completed accrual, and appears to be a reasonable surgical option. In ovarian cancer, minimally invasive surgery has been incorporated to manage early-stage, advanced-stage, and recurrent disease, as well as second-look procedures. Hand-assisted laparoscopy has also recently been described in managing larger volume primary and recurrent gynecologic cancers. Extraperitoneal laparoscopy for para-aortic and pelvic lymph node dissections has been shown to yield adequate nodal counts and to be safe and feasible in the management of gynecologic cancers. The Oncologist 2006;11:895-901

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“…Nos taux de complications sont comparables avec ceux de la littérature avec un taux de complications par voie transpé-ritonéale de 12,4 % (IC 95 % [10,[0][1][2][3][4][5][6][7][8][9][10][11][12][13][14]9]) soit 88 complications pour 708 patientes. Le cumul des plus grandes séries [3,4,[7][8][9][10]12,13,15] représente 1301 patientes (650 à 64 patientes par série) avec un taux moyen de complications de 6,46 % (3,6-9,1 %).…”

Section: Taux De Complicationsunclassified

“…Le cumul des plus grandes séries [3,4,[7][8][9][10]12,13,15] représente 1301 patientes (650 à 64 patientes par série) avec un taux moyen de complications de 6,46 % (3,6-9,1 %). Le taux de complications par voie extrapéritonéale dans notre série est de 13,4 % (IC 95 [11,[2][3][4][5][6][7][8][9][10][11][12][13][14][15]6]) soit 34 complications pour 254 patientes. Le cumul des plus grandes séries par voie extrapéritonéale [2,19,14] représente 116 patientes (44 à 32 patientes maximum) avec un taux moyen de complications de 12,5 % (10-15 %).…”

Section: Taux De Complicationsunclassified

“…Le taux de complications par voie extrapéritonéale dans notre série est de 13,4 % (IC 95 [11,[2][3][4][5][6][7][8][9][10][11][12][13][14][15]6]) soit 34 complications pour 254 patientes. Le cumul des plus grandes séries par voie extrapéritonéale [2,19,14] représente 116 patientes (44 à 32 patientes maximum) avec un taux moyen de complications de 12,5 % (10-15 %). Soixante-quinze pour cent des complications peropératoi-res sont apparues dans la première période de la série par voie d'abord transpéritonéale et extrapéritonéale.…”

Section: Taux De Complicationsunclassified

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Complications des lymphadénectomies cœlioscopiques en oncologie gynécologique : 1102 interventions chez 915 patientes

Cartron

Leblanc

Ferron

et al. 2005

Gynécologie Obstétrique & Fertilité

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Laparoscopic extraperitoneal paraaortic lymphadenectomy: a study of its applications in gynecological malignancies

Cited by 52 publications

References 16 publications

The use of harmonic shears (Ultracision) for laparoscopic lymphadenectomies in women with gynaecological malignancies

The use of harmonic shears (Ultracision) for laparoscopic lymphadenectomies in women with gynaecological malignancies

Role of Minimally Invasive Surgery in Gynecologic Cancers

Complications des lymphadénectomies cœlioscopiques en oncologie gynécologique : 1102 interventions chez 915 patientes

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