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Robotic retroperitoneal lymph node dissection in gynaecological neoplasms: comparison of extraperitoneal and transperitoneal lymphadenectomy

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Abstract

Objective

The main aim of our study is to review the till now available literature data on the role of robotic retroperitoneal lymph node dissection in gynaecological cancers by comparing the extraperitoneal versus the transperitoneal approach.

Methods

A thorough and systematic search was performed in electronic databases of PubMed and Scopus.

Results

The extraperitoneal approach is described in 148 patients. The age of the patients ranged from 26 to 78 years. The indications included cervical, endometrial and ovarian carcinoma in 113, 22 and 12 patients, respectively. The operative time ranged between 45 and 410 min. The number of dissected lymph nodes ranged from 3 to 25, while only 13 of them were found to be positive. The mean estimated blood loss during the operation was 77 ml (range <50–200 ml). Seven cases were converted to open. The duration of hospital stay ranged from 2 to 14 days. The transperitoneal approach is described in 898 patients. The age of the patients ranged from 15 to 89 years. Cervical, endometrial and ovarian carcinomas were the principal neoplasias present in 248, 449 and 164 patients, respectively. The operative time ranged from 19 to 633 min. The number of dissected lymph nodes ranged from 1 to 54, while the total number of patients with positive lymph nodes dissected was 56 patients. The estimated blood loss during the operation varied between 20 and 1800 ml. Only 9 out of 898 patients were converted to open. The duration of hospital stay ranged from 1 to 40 days.

Conclusion

A reliable definition of the “kind” of lymphadenectomy used in each study is the first step in order to reach safe conclusions. The lack of comparative studies, especially the randomized ones, cannot help us draw any safe conclusion regarding both the clinical outcomes and the possibility of any superiority of these different approaches (extraperitoneal and transperitoneal).

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Authors and Affiliations

  1. Gynaecological Oncology Department, Christie Hospital, Manchester, UK

    Christos Iavazzo

  2. 38, Seizani Str., Nea Ionia, 14231, Athens, Greece

    Christos Iavazzo

  3. First Department of Surgery, General Hospital of Attica “KAT”, Athens, Greece

    Ioannis D. Gkegkes

Authors
  1. Christos Iavazzo
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  2. Ioannis D. Gkegkes
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Correspondence to Christos Iavazzo.

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The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

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Iavazzo, C., Gkegkes, I.D. Robotic retroperitoneal lymph node dissection in gynaecological neoplasms: comparison of extraperitoneal and transperitoneal lymphadenectomy. Arch Gynecol Obstet 293, 11–28 (2016). https://doi.org/10.1007/s00404-015-3814-y

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