Laparoscopic pelvic lymphadenectomy in the staging of early carcinoma of the cervix

Article Abstract:

The prognosis for patients with cervical cancer (carcinoma of the cervix) is largely a function of the extent of metastasis (cancer spread) to nearby lymph nodes, which can only be determined accurately by lymph node biopsy. Biopsy prior to surgical intervention, however, adds another surgery, and is ideally performed before important treatment decisions are made. A method of obtaining biopsy specimens of lymph nodes in such cases under laparoscopic guidance (using a fiberoptic tube inserted through a small incision) is described. This is a much less invasive procedure than laparotomy (opening the abdomen surgically), lasting approximately 90 minutes. Thirty-nine patients with carcinoma of the cervix, including 15 who were older than 50, underwent the procedure. In two cases, metastases were seen in nodes that could not be removed but could be sampled by needle biopsy (insertion of a thick-bore needle into the node for extracting tissue). Between 1 and 15 nodes were removed from each side. The sensitivity (true positive results) and specificity (true negative results) of the procedure were 100 percent. Two complications occurred during surgery, but no unwanted laparotomies were performed. Laparoscopic lymphadenectomy is an alternative to laparotomy for biopsy analysis with reduced costs, risks, and effects on subsequent fertility. It is not suggested for obese patients or those with certain medical conditions, and should only be performed by surgeons with expertise in gynecologic oncology and laparoscopy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Prognosis, Cancer treatment, Cancer metastasis, Gynecology, Operative, Gynecological surgery, Lymph node excision

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Audit of preoperative and early complications of laparoscopic lymph node dissection in 1000 gynecologic cancer patients

Article Abstract:

The reliability and safety of minimal invasive surgery in gynecologic oncology is established in a large-scale study and the complication rate is estimated on a large sample size. Evidence is provided on a large series that laparoscopic lymph node dissection is safe. Laparoscopic surgery could be considered as the gold standard of assessment of the status of regional lymph nodes in gynecologic malignancies.

United States, Health aspects, Laparoscopic surgery, Clinical report

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De novo adhesions with extraperitoneal endosurgical para-aortic lymphadenectomy versus transperitoneal laparoscopic para-aortic lymphadenectomy: a randomized experimental study

Article Abstract:

Extraperitoneal laparoscopy causes fewer adhesions than transperitoneal laparoscopy when removing lymph nodes in the abdomen. This was the conclusion of a study in pigs. These techniques are used in women with cervical cancer.

Prevention, Adhesions

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