Paraaortic lymphadenectomy in oncologic gynecology

M. E. Căpîlna, B. Szabo, A. Toma, S. C. Rusu, S. Bîrciu, C. I. Puiac

Abstract: Performing paraaortic lymphadenectomy technique on 62 patients and those intra- and postoperative monitorization. The procedure was performed in 62 patients, included in the study. We analysed the indications, surgical procedures, intra- and postoperative complications, number of pelvic and paraaortic lymph nodes (metastatic and removed), and the survival rate with or without recurrences. From 62 patients, in 42 it was intervened for an advanced stage uterine cancer (IB2 stage or above), in 12 for a ovarian cancer, in 2 for a uterine carcinosarcoma, in 5 for a endometrial adenocarcinoma and in 1 for a undifferentiated pelvic sarcoma. Complications occurred intraoperatively in 10 patients (16.72%), and postoperatively in 9 patients (14.01%). The average number of removed pelvic and paraaortic lymph nodes was 24.66 (between 8 and 59) and 11.37 (between 3 and 32), respectively. Metastases were detected in pelvic lymph nodes in 26 patients (41.80%), and at those paraaortic limph nodes in 11 patients (17.44%). All eleven patients with paraaortic malignant limph nodes were positive for pelvic lymph nodes, also. The patients have been follow-up between the 2 and 53 months interval. Until present, 7 patients died as a result of malignant tumor, 1 it was excluded, and 55 survived.Conclusions. Paraaortic lymphadenectomy represents a feasible technique, encumbered with a relatively low rate of intraoperative complications. Postoperative complications seem to arise especially during prolonged interventions, but also in conjunction with retroperitoneal dissection. Its curative role should be established in the future.
Keywords: lymphadenectomy, ovarian cancer, limph nodes, metastases