Department of Oncology, Catholic University, Campobasso, Italy.
Eur J Surg Oncol. 2013 Jan;39(1):94-9. doi: 10.1016/j.ejso.2012.07.114. Epub 2012 Nov 9.
Paraaortic lymphadenectomy (PALN) is a standard part of many interventions, but currently there are no established care protocols effective in preventing gastro-intestinal (GI) symptoms. The aim of our study was to retrospectively evaluate patients with gynecologic cancers submitted to PALN, in order to evaluate if different approaches to the retroperitoneum could influence the radicality of the procedure and the onset of GI complications.
We divided 121 patients with gynecologic tumors submitted to PALN into 3 groups according the used right, left or combined left-right approach to the retroperitoneum, comparing the groups according the main surgical-pathological parameters, such as the number of nodes removed and the incidence and severity of GI complications.
The mean number of nodes removed did not significantly differ between the groups, while the mean number of positive nodes was significantly higher in combined approach. 39.8% of our patients experienced GI side effects, but those submitted to the combined approach had a significantly higher incidence of GI symptoms.
Our data demonstrate that the choice of the retroperitoneal approach could be the most important feature for the appearance of post-operative GI side effects, even if there is no significant difference on the radicality of PALN performed retroperitoneal approach.
腹主动脉旁淋巴结清扫术（PALN）是许多干预措施的标准组成部分，但目前尚无有效的既定护理方案来预防胃肠（GI）症状。我们研究的目的是回顾性评估接受 PALN 的妇科癌症患者，以评估对后腹膜采用不同方法是否会影响手术的根治性和 GI 并发症的发生。
我们将 121 名接受 PALN 的妇科肿瘤患者分为 3 组，根据使用的右侧、左侧或左右联合的后腹膜入路，比较各组主要手术-病理参数，如切除的淋巴结数量和 GI 并发症的发生率和严重程度。
各组间切除的淋巴结平均数无显著差异，但联合入路组的阳性淋巴结平均数明显更高。我们的 39.8%患者出现了 GI 副作用，但接受联合入路的患者 GI 症状的发生率明显更高。
我们的数据表明，腹膜后入路的选择可能是术后 GI 副作用出现的最重要特征，即使腹膜后入路的 PALN 根治性没有显著差异。
