Department of Surgery, Institut Gustave Roussy and University Paris Sud. Villejuif, France.
Gynecol Oncol. 2011 Nov;123(2):329-32. doi: 10.1016/j.ygyno.2011.07.011. Epub 2011 Aug 4.
To report the feasibility and reproducibility of single port extraperitoneal para-aortic lymphadenectomy in locally advanced cervical cancer.
The same single port was used for the transperitoneal step and the extraperitoneal approach used thereafter (in the absence of peritoneal disease) for the lymphadenectomy. Para-aortic lymphadenectomy was performed via a left-sided extraperitoneal approach.
Fourteen consecutive patients with cervical cancer underwent a laparoscopic staging procedure (3 stage IB2, 10 IIB and 1 stage IVA). No patient had para-aortic FDG uptake on PET/CT. In one case lymphadenectomy was unfeasible because of vascular anomalies of the renal vessels (low insertion of 2 left renal arteries). The median operative time was 190 min (range, 135-250). The median number of lymph nodes removed was 14 [range, 2-23]. The definitive pathological analysis revealed that three patients had metastatic disease. No conversion to conventional multiport laparoscopy was necessary.
This series reports that para-aortic lymphadenectomy technique via the extraperitoneal approach with a multichannel single port is feasible and reproducible.
报道腹腔镜下单端口经腹膜外途径施行广泛性子宫颈癌腹主动脉旁淋巴结切除术的可行性和可重复性。
采用同一单端口完成经腹腔步骤，然后采用经腹膜外途径（无腹膜疾病时）进行淋巴结切除术。经左侧腹膜外途径施行腹主动脉旁淋巴结切除术。
14 例连续宫颈癌患者接受了腹腔镜分期手术（3 例 IB2 期，10 例 IIB 期和 1 例 IVA 期）。PET/CT 检查未见患者存在腹主动脉旁 FDG 摄取。1 例患者因肾血管血管畸形（2 个左肾动脉低位插入）导致淋巴结切除术不可行。中位手术时间为 190 分钟（范围 135-250 分钟）。中位切除的淋巴结数为 14 个[范围 2-23 个]。最终病理分析显示 3 例患者存在转移病灶。无需转换为传统的多孔腹腔镜。
本系列研究表明，经多通道单端口行腹膜外途径的腹主动脉旁淋巴结切除术技术是可行和可重复的。
