Laparoscopic Lymphadenectomy for Isolated Lymph Node Recurrence in Gynecologic Malignancies

Abstract

Study ObjectiveTo assess the feasibility and efficacy of laparoscopic lymphadenectomy in patients with isolated lymph node recurrences (ILNR) who underwent initial surgery for gynecologic malignancy.DesignRetrospective study (Canadian Task Force classification II-3).SettingUniversity teaching hospital.PatientsSix patients with ILNR (one cervical, four ovarian, and one peritoneal) diagnosed between March 2003 and July 2010.InterventionLaparoscopic lymphadenectomy.Measurements and Main ResultsThe median age was 59.5 years (range 24-70) and the median body mass index was 21.7 (range 21.0-24.6). There was no unplanned conversion to laparotomy. The median operating time was 337.5 minutes (range 200-400), median hemoglobin change was 0.9 g/dL (range 0.4-2.6), and median hospital stay was 8.5 days (range 5-19). The median number of harvested lymph nodes was 20 (range 5-27) and those of positive lymph nodes was 4 (range 1-24). One patient had common iliac vein laceration with complete hemostasis achieved by intracorporeal suture. Postoperative lymphedema occurred in one patient and was managed conservatively. All patients were treated with adjuvant chemotherapy following laparoscopic lymphadenectomy.ConclusionLaparoscopic lymphadenectomy in patients with an ILNR is feasible and might be an alternative therapeutic strategy. Study ObjectiveTo assess the feasibility and efficacy of laparoscopic lymphadenectomy in patients with isolated lymph node recurrences (ILNR) who underwent initial surgery for gynecologic malignancy. To assess the feasibility and efficacy of laparoscopic lymphadenectomy in patients with isolated lymph node recurrences (ILNR) who underwent initial surgery for gynecologic malignancy. DesignRetrospective study (Canadian Task Force classification II-3). Retrospective study (Canadian Task Force classification II-3). SettingUniversity teaching hospital. University teaching hospital. PatientsSix patients with ILNR (one cervical, four ovarian, and one peritoneal) diagnosed between March 2003 and July 2010. Six patients with ILNR (one cervical, four ovarian, and one peritoneal) diagnosed between March 2003 and July 2010. InterventionLaparoscopic lymphadenectomy. Laparoscopic lymphadenectomy. Measurements and Main ResultsThe median age was 59.5 years (range 24-70) and the median body mass index was 21.7 (range 21.0-24.6). There was no unplanned conversion to laparotomy. The median operating time was 337.5 minutes (range 200-400), median hemoglobin change was 0.9 g/dL (range 0.4-2.6), and median hospital stay was 8.5 days (range 5-19). The median number of harvested lymph nodes was 20 (range 5-27) and those of positive lymph nodes was 4 (range 1-24). One patient had common iliac vein laceration with complete hemostasis achieved by intracorporeal suture. Postoperative lymphedema occurred in one patient and was managed conservatively. All patients were treated with adjuvant chemotherapy following laparoscopic lymphadenectomy. The median age was 59.5 years (range 24-70) and the median body mass index was 21.7 (range 21.0-24.6). There was no unplanned conversion to laparotomy. The median operating time was 337.5 minutes (range 200-400), median hemoglobin change was 0.9 g/dL (range 0.4-2.6), and median hospital stay was 8.5 days (range 5-19). The median number of harvested lymph nodes was 20 (range 5-27) and those of positive lymph nodes was 4 (range 1-24). One patient had common iliac vein laceration with complete hemostasis achieved by intracorporeal suture. Postoperative lymphedema occurred in one patient and was managed conservatively. All patients were treated with adjuvant chemotherapy following laparoscopic lymphadenectomy. ConclusionLaparoscopic lymphadenectomy in patients with an ILNR is feasible and might be an alternative therapeutic strategy. Laparoscopic lymphadenectomy in patients with an ILNR is feasible and might be an alternative therapeutic strategy.