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Systemic Laparoscopic Para-Aortic Lymphadenectomy to the Left Renal Vein
BACKGROUND: No large-scale clinical study has been done to show the standard surgical boundary and efficacy of laparoscopic para-aortic lymphadenectomy (LPAL). OBJECTIVES: Therfore, this study aimed to evaluate the feasibility, efficacy, and standard surgical boundary of LPAL performed up to the lef...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Society of Laparoendoscopic Surgeons
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6546154/ https://www.ncbi.nlm.nih.gov/pubmed/31223225 http://dx.doi.org/10.4293/JSLS.2018.00110 |
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author | Jung, Un Suk Choi, Joong Sub Bae, Jaeman Lee, Won Moo Eom, Jeong Min |
author_facet | Jung, Un Suk Choi, Joong Sub Bae, Jaeman Lee, Won Moo Eom, Jeong Min |
author_sort | Jung, Un Suk |
collection | PubMed |
description | BACKGROUND: No large-scale clinical study has been done to show the standard surgical boundary and efficacy of laparoscopic para-aortic lymphadenectomy (LPAL). OBJECTIVES: Therfore, this study aimed to evaluate the feasibility, efficacy, and standard surgical boundary of LPAL performed up to the left renal vein level in gynecological malignancies. METHODS: Medical records of 333 patients were retrospectively reviewed. All cases had gynecologic malignancies and had an operation including LPAL by a single surgical team between November 2003 and May 2018. RESULTS: Three hundred twenty-six patients underwent LPAL as part of their staging, restaging, or debulking surgery. Seven patients with isolated para-aortic lymph node recurrence underwent a repeat LPAL. The median age and body mass index were 54 years (range, 28–81 years) and 26.0 kg/m(2) (range, 20.3–37.2 kg/m(2)), respectively. The median operating time was 60 minutes (range, 24–135 minutes), and the median number of harvested para-aortic lymph nodes was 12 (range, 6–49). There were 11 cases of complications: 5 of major vessel injuries (3 inferior vena cava, 1 aorta, and 1 common iliac vein), 2 lymphocysts, 2 cases of chylous ascites, a cisterna chyli rupture, and 1 case of ureteric injury. There were 2 conversions to laparotomy: 1 left common iliac vein laceration that needed to be repaired and removal of an enlarged para-aortic lymph node completely. CONCLUSION: It is feasible and efficient to perform LPAL to the left renal vein level for women with gynecologic malignancies by well-trained gynecologic oncology surgeons according to our suggested standard surgical boundary. |
format | Online Article Text |
id | pubmed-6546154 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Society of Laparoendoscopic Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-65461542019-06-20 Systemic Laparoscopic Para-Aortic Lymphadenectomy to the Left Renal Vein Jung, Un Suk Choi, Joong Sub Bae, Jaeman Lee, Won Moo Eom, Jeong Min JSLS Scientific Paper BACKGROUND: No large-scale clinical study has been done to show the standard surgical boundary and efficacy of laparoscopic para-aortic lymphadenectomy (LPAL). OBJECTIVES: Therfore, this study aimed to evaluate the feasibility, efficacy, and standard surgical boundary of LPAL performed up to the left renal vein level in gynecological malignancies. METHODS: Medical records of 333 patients were retrospectively reviewed. All cases had gynecologic malignancies and had an operation including LPAL by a single surgical team between November 2003 and May 2018. RESULTS: Three hundred twenty-six patients underwent LPAL as part of their staging, restaging, or debulking surgery. Seven patients with isolated para-aortic lymph node recurrence underwent a repeat LPAL. The median age and body mass index were 54 years (range, 28–81 years) and 26.0 kg/m(2) (range, 20.3–37.2 kg/m(2)), respectively. The median operating time was 60 minutes (range, 24–135 minutes), and the median number of harvested para-aortic lymph nodes was 12 (range, 6–49). There were 11 cases of complications: 5 of major vessel injuries (3 inferior vena cava, 1 aorta, and 1 common iliac vein), 2 lymphocysts, 2 cases of chylous ascites, a cisterna chyli rupture, and 1 case of ureteric injury. There were 2 conversions to laparotomy: 1 left common iliac vein laceration that needed to be repaired and removal of an enlarged para-aortic lymph node completely. CONCLUSION: It is feasible and efficient to perform LPAL to the left renal vein level for women with gynecologic malignancies by well-trained gynecologic oncology surgeons according to our suggested standard surgical boundary. Society of Laparoendoscopic Surgeons 2019 /pmc/articles/PMC6546154/ /pubmed/31223225 http://dx.doi.org/10.4293/JSLS.2018.00110 Text en © 2019 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way. |
spellingShingle | Scientific Paper Jung, Un Suk Choi, Joong Sub Bae, Jaeman Lee, Won Moo Eom, Jeong Min Systemic Laparoscopic Para-Aortic Lymphadenectomy to the Left Renal Vein |
title | Systemic Laparoscopic Para-Aortic Lymphadenectomy to the Left Renal Vein |
title_full | Systemic Laparoscopic Para-Aortic Lymphadenectomy to the Left Renal Vein |
title_fullStr | Systemic Laparoscopic Para-Aortic Lymphadenectomy to the Left Renal Vein |
title_full_unstemmed | Systemic Laparoscopic Para-Aortic Lymphadenectomy to the Left Renal Vein |
title_short | Systemic Laparoscopic Para-Aortic Lymphadenectomy to the Left Renal Vein |
title_sort | systemic laparoscopic para-aortic lymphadenectomy to the left renal vein |
topic | Scientific Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6546154/ https://www.ncbi.nlm.nih.gov/pubmed/31223225 http://dx.doi.org/10.4293/JSLS.2018.00110 |
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