Comparison of the Results of Conventional and Laparoscopic Methods of Lymph Node Dissection Performed in Endometrial Cancer Surgery

Abstract

Objective: The aim of this study was to determine a current approach to en bloc para-aortic lymphadenectomy and to compare the results of this new approach performed by way of laparotomy and endoscopically. Methods: This study was conducted on 191 patients with endometrial cancer (EC) who had undergone para-aortic lymph node (PaLN) dissection with the current method (en. bloc paraaortic lymphadenectomy; protect inferior mesenteric artery and superior hypogastric plexus) between January 2015 and September 2019. A description of the paraaortic lymphadenectomy technique was made in this study. Harvested lymph node counts, operational information, pathological features, postoperative complications, recurrence were presented. Results: A total of 191 EC patients were analyzed in two separate groups with regard to surgical approach. Open and minimally invasive surgery was composed of 141 and 50 patients, respectively. There was no difference between the groups in respect of age, body mass index, menopausal status, anesthesia time, chylous ascites, the presence of recurrence. We found in open surgery group that pre-operative CA125 level, amount of intraoperative bleeding, erythrocyte suspension transfusion, number of PaLNs, metastatic PaLN counts, and early postoperative complications were significantly higher than the other group. Conclusion: The current method has some advantages such as protecting normal body structures, resulting in the same lymph node counts with published articles by other authors previously, and having lower recurrence rates. Two approaches of the current technique are feasible, easy to perform and effective.

Keywords

• paraaortic lymphadenectomy
• method
• endometrial cancer
• minimally invasive surgery