OBJECTIVE: Compare two approaches for laparoscopic infrarenal lymphadenectomy. METHODS: Retrospective chart review. Statistical analyses with SPSS. RESULTS: @entity1 : 4 @entity5 , 75 clinical stage I/II @entity1204 , 36 clinically stage I/II @entity43 . 36 transperitoneal approaches; 79 extraperitoneal approaches. Both groups had similar age, 58years (range 29-80), BMI of 25 (range 18-41), @entity190 , 150cm(3) (range 25-1500), and hospital stay, 1day (range 1-6). The extraperitoneal surgery took longer (240 v 202min; p=.001); yielded more nodes (50 v 41; p=.004). Extraperitoneal approach yielded more inframesenteric (14 v 10; p=.036), and infrarenal nodes (14 v 9; p=.001). 25% of cervical, 19% of endometrial and 14% of @entity43 @entity1 had @entity3 in radiographically negative infrarenal nodes. 50% of cervical, 33% of endometrial and 17% of @entity43 @entity1 had therapy altered by aortic lymphadenectomy. When the inframesenteric nodes were positive, 63% of endometrial and 80% of @entity43 @entity1 had infrarenal @entity3 . More @entity3 were identified with increasing aortic node count. Extraperitoneal lymphadenectomy had no learning curve (p=0.320), while transperitoneal lymphadenectomy did (p=0.016). Higher BMI @entity1 had lower aortic node yields by transperitoneal (p=.057) but not extraperitoneal approach (p=.578). Among the 14 @entity1 whose BMI was 35-41, mean extraperitoneal total aortic nodal yield was 30; transperitoneal yield was 6. CONCLUSIONS: Infrarenal aortic lymphadenectomy may offer higher aortic nodal yields, even in @entity1 with BMI's of 45. Larger prospective studies are needed to confirm whether this dissection in high-risk @entity1 ensures more accurate therapy, and possibly improves cure rates.

Infrarenal lymphadenectomy for gynecological XXXX : Two laparoscopic approaches.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity43 :: ('MESH:D010051', 'Disease') :: ['tubal/ovarian cancer', 'ovarian cancer'] @entity1204 :: ('MESH:D016889', 'Disease') :: ['endometrial carcinoma'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity5 :: ('MESH:D009369', 'Disease') :: ['stage II/III cervical carcinoma'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases']
@entity5 :: (MESH:D009369,Disease) :: ['malignancies']
