Safety and Feasibility Analysis of Laparoscopic Lymphadenectomy in Pelvic Gynecologic Malignancies: A Prospective Study

Benito, Virginia; Romeu, Silvia; Esparza, Miriam; Carballo, Sonia; Arencibia, Octavio; Medina, Norberto; Lubrano, Amina

doi:10.1097/igc.0000000000000555

Cited by 22 publications

(16 citation statements)

References 22 publications

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“…The emerging laparoscopic approach aims at reducing surgical morbidities such as postoperative pain, blood loss and hospital stay. Laparoscopic lymphadenectomy is a safe and feasible procedure; however, it is not free of complications (10) and there is no consensus about its ability to reduce the risk of lymphedema, even though in a recent paper the patients who underwent an open surgical procedure experienced a higher incidence of lymphedema than those who were treated with endoscopic surgery (11).…”

Section: Abstract Lower Body Lymphedema Is a Chronic Condition And Amentioning

confidence: 99%

Lower Body Lymphedema in Patients with Gynecologic Cancer

Biglia

Zanfagnin

Daniele

et al. 2017

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Section: Abstract Lower Body Lymphedema Is a Chronic Condition And Amentioning

confidence: 99%

Lower Body Lymphedema in Patients with Gynecologic Cancer

Biglia

Zanfagnin

Daniele

et al. 2017

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“…However, the majority of patients undergoing a pelvic and/or para-aortic lymphadenectomy in this setting will ultimately have negative lymph nodes, yet are subjected to the morbidity of lymphadenectomy. Potential lymphadenectomy-associated complications include bleeding, neurovascular injury, infection, lymphocyst development, and debilitating lymphedema [5,6]. Thus, there is great interest in developing novel nodal assessment techniques that minimize morbidity and maximize detection of lymphatic metastases.…”

Section: Introductionmentioning

confidence: 99%

Sentinel lymph node detection rates using indocyanine green in women with early-stage cervical cancer

Beavis

Salazar‐Marioni

Sinno

et al. 2016

Gynecologic Oncology

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Objective Our study objective was to determine feasibility and mapping rates using indocyanine green (ICG) for sentinel lymph node (SLN) mapping in early-stage cervical cancer. Methods We performed a retrospective review of all women who underwent SLN mapping with ICG during primary surgical management of early-stage cervical cancer by robotic-assisted radical hysterectomy (RA-RH) or fertility-sparing surgery. Patients were treated at two high-volume centers from 10/2012 to 02/2016. Completion pelvic lymphadenectomy was performed after SLN biopsy; additionally, removal of clinically enlarged/suspicious nodes was part of the SLN treatment algorithm. Results Thirty women with a median age of 42.5 and BMI of 26.5 were included. Most (90%) had stage IB disease, and 67% had squamous histology. RA-RH was performed in 86.7% of cases. One patient underwent fertility-sparing surgery. Median cervical tumor size was 2.0 cm. At least one SLN was detected in all cases (100%), with bilateral mapping achieved in 87%. SLN detection was not impacted by tumor size and was most commonly identified in the hypogastric (40.3%), obturator (26.0%), and external iliac (20.8%) regions. Five cases of lymphatic metastasis were identified (16.7%): three in clinically enlarged SLNs, one in a clinically enlarged non-SLN, and one case with cytokeratin positive cells in an SLN. All metastatic disease would have been detected even if full lymphadenectomy had been omitted from our treatment algorithm, Conclusions SLN mapping with ICG is feasible and results in high detection rates in women with early-stage cervical cancer. Prospective studies are needed to determine if SLN mapping can replace lymphadenectomy in this setting.

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“…For these indications, laparoscopic and robotic assistance allows for excellent exposure and visualization of the pelvis while minimizing postoperative pain, complications and convalescence time [13]. rPLND is accomplished via a trans-peritoneal approach utilizing five ports, and provides improved visualization of both the iliac and obturator nodes compared to oPLND [14].…”

Section: Introductionmentioning

confidence: 99%

Robotic-Assisted Transperitoneal Pelvic Lymphadenectomy for Metastatic Melanoma: Early Outcomes Compared with Open Pelvic Lymphadenectomy

Dossett

Castner

Pow‐Sang

et al. 2016

Journal of the American College of Surgeons

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Background In the absence of iliac or obturator nodal involvement, the role of pelvic lymphadenectomy (PLND) for melanoma is controversial, but for select patients long-term survival may be achieved with the combination of superficial inguinal (inguinofemoral) and pelvic lymphadenectomy. Open PLND (oPLND) is often limited in visual exposure and may be associated with significant postoperative pain. Robotic PLND (rPLND) is a minimally invasive technique that provides excellent visualization of the iliac and obturator nodes. Outcomes comparing the open and robotic techniques for have not been previously reported for patients with melanoma. Study Design We reviewed our experience with rPLND for melanoma and compared clinical and pathologic results to oPLND. We evaluated operative times, nodal yield and short-term oncologic outcomes. Results 13 rPLND (2013–2015) (15 attempted, 87% success rate) and 25 oPLND (2010–2015) consecutive cases were completed. PLND was combined with an open inguinofemoral dissection in 8 of 13 (62%) robotic and 17 of 25 (68%) open cases. Median length of stay (LOS) was shorter in the rPLND group with 1.0 versus 3.5 days for pelvic only cases (p<0.001) and 2.5 versus 4.0 days (p<0.001) for combined ilioinguinal cases. Median operative time (227 versus 230 minutes, p=0.96) and nodal yield (11 versus 10 nodes, p=0.53) were not different between rPLND and oPLND. Conclusions rPLND offers a safe, effective minimally invasive approach to resect the pelvic lymph nodes in patients with melanoma, with no significant difference in nodal yield or operative times, but a shorter LOS compared to oPLND.

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Safety and Feasibility Analysis of Laparoscopic Lymphadenectomy in Pelvic Gynecologic Malignancies: A Prospective Study

Cited by 22 publications

References 22 publications

Lower Body Lymphedema in Patients with Gynecologic Cancer

Lower Body Lymphedema in Patients with Gynecologic Cancer

Sentinel lymph node detection rates using indocyanine green in women with early-stage cervical cancer

Robotic-Assisted Transperitoneal Pelvic Lymphadenectomy for Metastatic Melanoma: Early Outcomes Compared with Open Pelvic Lymphadenectomy

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