Extraperitoneal laparoscopy for para-aortic lymphadenectomy in endometrial carcinoma staging: an approach with higher efficiency

Abstract Background Removing more inframesenteric nodes is not only significantly increases the likelihood of finding metastasis for endometrial cancer, but also can add survival advantage. As most patients diagnosed with endometrial cancer are overweight or obesity, a high efficiency approach is im...

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Autores principales:	Wei Zhang, Lingfang Xia, Xiaotian Han, Xingzhu Ju, Xiaohua Wu, Xiaojun Chen
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Endometrial carcinoma Extraperitoneal Transperitoneal Laparotomy Minimally invasive Lymphadenectomy Surgery RD1-811 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/4e9d65df8abb40e0b930811fa2a9f4e3
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spelling	oai:doaj.org-article:4e9d65df8abb40e0b930811fa2a9f4e32021-11-14T12:33:40ZExtraperitoneal laparoscopy for para-aortic lymphadenectomy in endometrial carcinoma staging: an approach with higher efficiency10.1186/s12957-021-02416-x1477-7819https://doaj.org/article/4e9d65df8abb40e0b930811fa2a9f4e32021-11-01T00:00:00Zhttps://doi.org/10.1186/s12957-021-02416-xhttps://doaj.org/toc/1477-7819Abstract Background Removing more inframesenteric nodes is not only significantly increases the likelihood of finding metastasis for endometrial cancer, but also can add survival advantage. As most patients diagnosed with endometrial cancer are overweight or obesity, a high efficiency approach is important. Aim of this study was to compare the surgical outcomes of extraperitoneal laparoscopic, transperitoneal laparoscopic, and laparotomic para-aortic lymphadenectomy in endometrial carcinoma staging. Methods We retrospectively reviewed data of all patients diagnosed with primary endometrial carcinoma who were treated at the Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center from 1 January 2017 to 31 December 2019. The numbers of para-aortic lymph nodes, surgical time, complications, blood loss and hospital stay were compared. The patients’ medical records and pathological reports were carefully reviewed. Statistical significance was defined as p < 0.05. Results We retrospectively compared patients who underwent extraperitoneal laparoscopy (Group E, n = 20), transperitoneal laparoscopy (group T, n = 21), and laparotomy (group L, n = 135). The median number of para-aortic lymph nodes was significantly higher in group E than in groups T and L (9.5, 5, and 6, respectively; p = 0.004 and 0.0004, respectively). All patients in group E underwent successfully dissection to the renal vessel level. The median operation time was significantly shorter in group L than in groups T and E (94, 174, and 233 min, respectively; p < 0.0001). The median estimated blood loss volume was higher in group L than in groups T and E (200, 100, and 142.5 ml, respectively; all comparisons p < 0.001), and the length of hospital stay was significantly longer in group L than in Groups T and E (6, 5, and 6 days, respectively; all comparisons p < 0.001). Conclusion The extraperitoneal laparoscopic approach for staging endometrial carcinoma harvested higher numbers of para-aortic lymph nodes which could be considered for endometrial carcinoma staging, especially for para-aortic lymph node harvest.Wei ZhangLingfang XiaXiaotian HanXingzhu JuXiaohua WuXiaojun ChenBMCarticleEndometrial carcinomaExtraperitonealTransperitonealLaparotomyMinimally invasiveLymphadenectomySurgeryRD1-811Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENWorld Journal of Surgical Oncology, Vol 19, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Endometrial carcinoma Extraperitoneal Transperitoneal Laparotomy Minimally invasive Lymphadenectomy Surgery RD1-811 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Endometrial carcinoma Extraperitoneal Transperitoneal Laparotomy Minimally invasive Lymphadenectomy Surgery RD1-811 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Wei Zhang Lingfang Xia Xiaotian Han Xingzhu Ju Xiaohua Wu Xiaojun Chen Extraperitoneal laparoscopy for para-aortic lymphadenectomy in endometrial carcinoma staging: an approach with higher efficiency
description	Abstract Background Removing more inframesenteric nodes is not only significantly increases the likelihood of finding metastasis for endometrial cancer, but also can add survival advantage. As most patients diagnosed with endometrial cancer are overweight or obesity, a high efficiency approach is important. Aim of this study was to compare the surgical outcomes of extraperitoneal laparoscopic, transperitoneal laparoscopic, and laparotomic para-aortic lymphadenectomy in endometrial carcinoma staging. Methods We retrospectively reviewed data of all patients diagnosed with primary endometrial carcinoma who were treated at the Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center from 1 January 2017 to 31 December 2019. The numbers of para-aortic lymph nodes, surgical time, complications, blood loss and hospital stay were compared. The patients’ medical records and pathological reports were carefully reviewed. Statistical significance was defined as p < 0.05. Results We retrospectively compared patients who underwent extraperitoneal laparoscopy (Group E, n = 20), transperitoneal laparoscopy (group T, n = 21), and laparotomy (group L, n = 135). The median number of para-aortic lymph nodes was significantly higher in group E than in groups T and L (9.5, 5, and 6, respectively; p = 0.004 and 0.0004, respectively). All patients in group E underwent successfully dissection to the renal vessel level. The median operation time was significantly shorter in group L than in groups T and E (94, 174, and 233 min, respectively; p < 0.0001). The median estimated blood loss volume was higher in group L than in groups T and E (200, 100, and 142.5 ml, respectively; all comparisons p < 0.001), and the length of hospital stay was significantly longer in group L than in Groups T and E (6, 5, and 6 days, respectively; all comparisons p < 0.001). Conclusion The extraperitoneal laparoscopic approach for staging endometrial carcinoma harvested higher numbers of para-aortic lymph nodes which could be considered for endometrial carcinoma staging, especially for para-aortic lymph node harvest.
format	article
author	Wei Zhang Lingfang Xia Xiaotian Han Xingzhu Ju Xiaohua Wu Xiaojun Chen
author_facet	Wei Zhang Lingfang Xia Xiaotian Han Xingzhu Ju Xiaohua Wu Xiaojun Chen
author_sort	Wei Zhang
title	Extraperitoneal laparoscopy for para-aortic lymphadenectomy in endometrial carcinoma staging: an approach with higher efficiency
title_short	Extraperitoneal laparoscopy for para-aortic lymphadenectomy in endometrial carcinoma staging: an approach with higher efficiency
title_full	Extraperitoneal laparoscopy for para-aortic lymphadenectomy in endometrial carcinoma staging: an approach with higher efficiency
title_fullStr	Extraperitoneal laparoscopy for para-aortic lymphadenectomy in endometrial carcinoma staging: an approach with higher efficiency
title_full_unstemmed	Extraperitoneal laparoscopy for para-aortic lymphadenectomy in endometrial carcinoma staging: an approach with higher efficiency
title_sort	extraperitoneal laparoscopy for para-aortic lymphadenectomy in endometrial carcinoma staging: an approach with higher efficiency
publisher	BMC
publishDate	2021
url	https://doaj.org/article/4e9d65df8abb40e0b930811fa2a9f4e3
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Extraperitoneal laparoscopy for para-aortic lymphadenectomy in endometrial carcinoma staging: an approach with higher efficiency

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