Laparoscopic para-aortic lymphadenectomy: Technique and surgical outcomes

Abstract

Objective: Pelvic and para-aortic lymph node dissection is an important part of staging surgery. Aim of this study is to evaluate perioperative outcomes of patients, who underwent laparoscopic para-aortic lymphadenectomy for gynecological cancer in a single center over a period of 7 years, based on body mass index (BMI), and to present the surgical technique in steps.

Methods: Data of patients who underwent para-aortic lymphadenectomy at gynecological oncology department of a tertiary center in between March 2013 and July 2020 were analyzed retrospectively. Patients were evaluated in two groups according to their BMI (< 30 kg/m(2) as non-obese and >= 30 kg/m(2) as obese groups). Surgical technique is described in steps. Perioperative outcomes of the two groups were evaluated.

Results: A total of 230 patients were included in the study. BMI was >= 30 at 58.46 % of the patients. Perioperative features were not significantly affected by the patient's BMI with the presented surgical technique, however, collected para-aortic lymph node numbers were higher in the group with BMI <30, though sufficient number of lymph nodes were achieved in both groups.

Conclusion: Although some technical difficulties may be encountered, laparoscopic para-aortic lymphadenectomy is feasable in gynecologic oncological surgery independent of BMI. However, surgical experience is important. (C) 2020 Elsevier Masson SAS. All rights reserved.