Article (Scientific journals)
Lomboaortic Lymphadenectomy in Gynecological Oncology: Laparotomy, Laparoscopy or Robot-Assisted Laparoscopy?
Kerbage, Y.; Kakkos, A.; Kridelka, Frédéric et al.
2020In Annals of Surgical Oncology, 27 (10), p. 3891-3897
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Abstract :
[en] BACKGROUND: The outcomes of paraaortic lymphadenectomy were compared for the treatment of gynecological malignancies to identify the most appropriate surgical approach. METHODS: Our retrospective, multicentric study included 1304 patients who underwent paraaortic lymphadenectomy for gynecological malignancies. The patients were categorized into the following five groups based on treatment type: transperitoneal laparoscopy (group A, n = 198), extraperitoneal laparoscopy (group B, n = 681), robot-assisted transperitoneal laparoscopy (group C, n = 135), robot-assisted extraperitoneal laparoscopy (group D, n = 44), and laparotomy (group E, n = 246). RESULTS: The prevalence of cancer types differed according to the surgical approach: there were more ovarian cancers in group E and more cervical cancers in groups B and D (p < 0.001). Estimated blood loss was higher in group E (844.2 mL) than in groups treated with minimally invasive interventions (115.8-141.5 mL, p < 0.005). For infrarenal dissection, fewer nodes were removed in group C compared with the other approaches (16 vs. 21 nodes, respectively, p < 0.05). The average operative time ranged from 169 min for group A to 247 min for group E (p < 0.001). Length of hospital stay was 14 days for group E versus 3.5 days for minimally invasive procedures (p < 0.05). The early postoperative grade 3 and superior Dindo-Clavien complications occurred in 9-10% of the patients in groups B-D, 15% of the patients in group E, and only 3% and 4% for groups A and C, respectively. The most common complication was lymphocele. CONCLUSIONS: Laparotomy increases preoperative and postoperative morbidity. The robot-assisted transperitoneal approach demonstrated a poorer lymph node yield than laparotomy and extraperitoneal approaches.
Disciplines :
Author, co-author :
Kerbage, Y.
Kakkos, A.
Kridelka, Frédéric ;  Université de Liège - ULiège > Département des sciences cliniques > Gynécologie-Obstétrique
Lambaudie, E.
Bats, A. S.
Hébert, T.
GOFFIN, Frédéric ;  Centre Hospitalier Universitaire de Liège - CHU > Département de gynécologie-obstétrique > Secteur gynécologie
Wallet, J.
Leblanc, E.
Hudry, D.
Narducci, F.
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Title :
Lomboaortic Lymphadenectomy in Gynecological Oncology: Laparotomy, Laparoscopy or Robot-Assisted Laparoscopy?
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Journal title :
Annals of Surgical Oncology
Publisher :
Lippincott Williams & Wilkins, United States - New York
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Issue :
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Peer reviewed :
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since 30 October 2020


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