Prospective Randomized Trial Comparing Transperitoneal Versus Extraperitoneal Laparoscopic Aortic Lymphadenectomy for Surgical Staging of Endometrial and Ovarian Cancer: The STELLA Trial
| Autor: | Javier F. Magrina, Oriol Puig Puig, Javier de la Torre, Assumpció Pérez-Benavente, Berta Díaz-Feijoo, Antonio Gil-Moreno, Eva Colas, Silvia Cabrera, Cristina Centeno, Jose Luis Sánchez-Iglesias, Blanca Gil-Ibáñez, Alejandro Correa-Paris, Silvia Franco-Camps |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment law.invention 03 medical and health sciences 0302 clinical medicine Robotic Surgical Procedures Randomized controlled trial Surgical oncology law Humans Medicine Prospective Studies Prospective cohort study Laparoscopy Aged Neoplasm Staging Aged 80 and over Ovarian Neoplasms 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Endometrial cancer Perioperative Middle Aged medicine.disease Endometrial Neoplasms Surgery Oncology 030220 oncology & carcinogenesis Lymph Node Excision Female Lymphadenectomy business Ovarian cancer |
| Zdroj: | Annals of Surgical Oncology. 23:2966-2974 |
| ISSN: | 1534-4681 1068-9265 |
| DOI: | 10.1245/s10434-016-5229-9 |
| Popis: | There is an ongoing debate on which approach, transperitoneal or extraperitoneal, is superior for the performance of laparoscopic aortic lymphadenectomy (LPA-LND) for the surgical staging of gynecologic cancer. A prospective randomized trial (STELLA trial) was designed to compare the perioperative outcomes and node retrieval of extraperitoneal versus transperitoneal aortic lymphadenectomy by laparoscopy or robot-assisted laparoscopy. Patients with endometrial or ovarian carcinoma requiring aortic lymphadenectomy for surgical staging were randomized to an extraperitoneal or transperitoneal approach by laparoscopy or robot-assisted laparoscopy between June 2012 and July 2014. A total of 60 patients were entered into the study, 48 with endometrial cancer (80 %) and 12 with ovarian cancer (20 %). Thirty-one patients (51.6 %) were randomly assigned to the extraperitoneal group and 29 to the transperitoneal group (48.3 %). The means LPA-LND operating time was 90 min in both group (p = 0.343). The mean (range) blood loss was 105 (10–400) mL for extraperitoneal versus 100 (5–1000) mL for transperitoneal group (p = 0.541). There were no differences in the number of collected lymph nodes between the two groups [median (range) for extraperitoneal 12 (4–41) vs. 13 (4–29) for transperitoneal (p = 0.719)]. The extraperitoneal and transperitoneal approaches for laparoscopic and robotic aortic lymphadenectomy provide similar perioperative outcomes and nodal yields. Trial registration: The STELLA trial is registered at the US National Institutes of Health (ClinicalTrials.gov) #NCT01810874. |
| Databáze: | OpenAIRE |
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