Robotic Extraperitoneal Paraaortic Lymphadenectomy in Gynecological Cancers: Feasibility, Safety, and Short-Term Outcomes of Isolated and Combined Procedures
| Autor: | Fabrice Lecuru, Chérazade Bensaid, Anne-Sophie Bats, Myriam Mimouni, N Douay-Hauser, Claude Nos, Julien Seror |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty Genital Neoplasms Female medicine.medical_treatment Da Vinci Surgical System Postoperative Complications Robotic Surgical Procedures Paraaortic lymph nodes medicine Humans Laparoscopy Peritoneal Cavity Aorta Retrospective Studies Cervical cancer Hysterectomy medicine.diagnostic_test business.industry Endometrial cancer Obstetrics and Gynecology Perioperative Middle Aged Prognosis medicine.disease Combined Modality Therapy Surgery Treatment Outcome Oncology Feasibility Studies Lymph Node Excision Female Lymphadenectomy Lymph Nodes business |
| Zdroj: | International Journal of Gynecologic Cancer. 24:1486-1492 |
| ISSN: | 1525-1438 1048-891X |
| Popis: | ObjectiveThe aim of our study was to report the technique, the feasibility, and perioperative results of robotic extraperitoneal paraaortic lymphadenectomy in gynecological cancers performed for isolated or combined procedures.MethodsThis is a retrospective study of 24 consecutive patients undergoing robotic extraperitoneal paraaortic lymphadenectomy using the Da Vinci Surgical system (Intuitive Inc, Sunnyvale, CA) (cervical cancer, n = 15; high-risk endometrial cancer, n = 8; and ovarian cancer, n = 2, including 1 synchronous tumor). Extraperitoneal paraaortic lymphadenectomy was performed using the surgical technique previously described by laparoscopy.ResultsOf the 24 included patients, 12 patients had isolated robotic extraperitoneal paraaortic lymphadenectomy, whereas the others underwent the following associated procedures: total hysterectomy with bilateral salpingo-oophorectomy, pelvic lymphadenectomy, and omentectomy (n = 7); pelvic transperitoneal lymphadenectomy (n = 3), laparotomic Bricker procedure (n = 1), and colpectomy (n = 1). The median age of patients was 55 (42–64) years, and body mass index was 24.1 kg/m2 (20.9–26.1). The operation was completed in all patients except three with associated procedures. Perioperative difficulties were encountered in 9 patients (gas leakage, n = 7; adhesions, n = 2; and dissection difficulties, n = 1). The number of removed paraaortic lymph nodes was 18 (14–25). The operating times were 180 (150–210) minutes for isolated extraperitoneal paraaortic lymphadenectomy and 240 (180–300) minutes in case of associated procedures. There were 2 intraoperative (pneumothorax and renal artery injury) and 5 postoperative (3 grades 1–2 and 2 grade 3) complications.ConclusionsIf robotic-assisted extraperitoneal paraaortic lymphadenectomy seems feasible in case of isolated procedure, further studies are required to prove its benefit compared with conventional laparoscopy. |
| Databáze: | OpenAIRE |
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