Universität zu Köln

Jacob, Anna, Plaikner, Andrea, Schneider, Achim, Favero, Giovanni, Tozzi, Roberto, Mallmann, Peter, Domroese, Christian, Martus, Peter, Marnitz, Simone, Barinoff, Jana and Kohler, Christhardt (2020). Comparison of surgical and pathological parameters after laparoscopic transperitoneal pelvic/para-aortic lymphadenectomies. Int. J. Gynecol. Cancer, 30 (11). S. 1798 - 1803. LONDON: BMJ PUBLISHING GROUP. ISSN 1525-1438

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Abstract

Objective Lymphadenectomy is an integral part of surgical staging and treatment for patients with gynecologic malignancies. Since its introduction, laparoscopic lymphadenectomy has proved feasible, safe, and oncologically adequate compared with open surgery while morbidity is lower and hospital stay considerably shorter. The aim of this study was to examine if surgical outcomes may be improved after the initial learning curve is complete. Methods An analysis of 2535 laparoscopic pelvic and/or para-aortic lymphadenectomies was performed between July 1994 and March 2018 by one team of gynecologic oncology surgeons but with the consistent supervision of a consultant surgeon. Data were collected prospectively evaluating operative time, intra-operative and post-operative complications, number of lymph nodes, and body mass index (BMI). Previously published data of 650 patients treated after introduction of the method (period 1, 1994-2003) were compared with the latter 524 patients (period 2, 2014-2018). Results The median age of the 2535 patients was 43 years (IQR 34-57). The most common indication for pelvic and/or para-aortic lymphadenectomy was cervical cancer (n=1893). Operative time for para-aortic lymph node dissection was shorter in period 2 (68 vs 100 min, p<0.001). The number of harvested lymph nodes was increased for pelvic (19.2 (range 2-52) vs 21.9 (range 4-87)) and para-aortic lymphadenectomy (10.8 (range 1-52) vs 14.4 (range 4-64)), p<0.001. BMI did not have a significant influence on node count or operative time, with BMI ranging from 14.6 to 54.1 kg/m(2). In contrast to period 1 (n=18, 2.9%), there were no intra-operative complications in period 2 (n=0, 0.0%, p<0.001) whereas post-operative complications were similar (n=35 (5.8%) in period 1; n=38 (7.6%) in period 2; p=0.32). Conclusion In this large cohort of patients who underwent laparoscopic transperitoneal lymphadenectomy, lymph node count and peri-operative complications improved after the initial learning curve.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Jacob, Anna UNSPECIFIED UNSPECIFIED UNSPECIFIED Plaikner, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Schneider, Achim UNSPECIFIED UNSPECIFIED UNSPECIFIED Favero, Giovanni UNSPECIFIED UNSPECIFIED UNSPECIFIED Tozzi, Roberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Mallmann, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Domroese, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Martus, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Marnitz, Simone UNSPECIFIED UNSPECIFIED UNSPECIFIED Barinoff, Jana UNSPECIFIED UNSPECIFIED UNSPECIFIED Kohler, Christhardt UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-313239
DOI:	10.1136/ijgc-2020-001677
Journal or Publication Title:	Int. J. Gynecol. Cancer
Volume:	30
Number:	11
Page Range:	S. 1798 - 1803
Date:	2020
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1525-1438
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LYMPH-NODE DISSECTION; INFRARENAL PARAAORTIC LYMPHADENECTOMY; RADICAL HYSTERECTOMY; CERVICAL-CANCER; LEARNING-CURVE; CARCINOMA; OUTCOMES; SURGERY Multiple languages Oncology; Obstetrics & Gynecology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31323