Laparoscopic infrarenal paraaortic lymph node dissection for restaging of carcinoma of the ovary or fallopian tube.

Abstract

The purpose of the study was to investigate the feasibility of laparoscopic paraaortic lymphadenectomy in the restaging of ovarian carcinomas. Nine patients in a referral center seen initially with ovarian (eight patients) or tubal (one patient) carcinoma who had experienced substandard staging during a previous laparotomy or laparoscopy underwent laparoscopic paraaortic lymphadenectomy as part of a surgical staging procedure that included peritoneal fluid sampling and multiple staging biopsies. Omentectomy, appendectomy, pelvic lymphadenectomy, contralateral salpingo-oophorectomy, salpingectomy, or laparoscopically assisted total vaginal hysterectomy was performed during the same operative session when necessary. All nine lymphadenectomies up to the level of the renal veins were successfully completed. The postoperative periods were uneventful, with an average postoperative stay of 2.8 days. Laparoscopic surgery may be an acceptable procedure for paraaortic lymph node sampling, sparing the patient a restaging laparotomy.