Comparison of Nodal Harvest Between Laparoscopic and Open Pelvic Lymph Node Dissection

Abstract

Pelvic lymph node dissection (PLND) is the gold standard for the detection of micrometastasis in the pelvic nodes. PLND is done as a staging procedure for gynecological and genitourinary malignancies. The therapeutic benefit of PLND remains controversial. PLND is done either by open or laparoscopic approach. The efficacy of each approach is not well studied. The data of various surgeries in which pelvic nodal dissection was a part of the procedure were collected from the hospital records for the period from 2014 to 2019. Pathological reports were analyzed with regard to the primary aim of the study. Possible confounding factors for the noted difference like body mass index, grade of the tumor, and surgical technique were analyzed. Statistical analysis was performed using SPSS 20. The mean nodal harvest by laparoscopic technique was more compared to open technique. The difference was statistically significant in surgical staging (P = 0.001). The nodal yield was more for patients with higher BMI though the number was not statistically significant. There was a statistically significant difference in the nodal yield between well-differentiated and poorly differentiated tumors. The nodal yield by laparoscopic technique of PLND was statistically significant than that by open technique (P = 0.001). The lymph nodal yield in pelvic lymph node dissection by laparoscopic technique was higher than that by the open technique.