Abstract
Background
Lymphadenopathy-identified incidentally during computed tomography (CT) mandates a tissue diagnosis. When percutaneous techniques are not possible, surgical tissue diagnosis becomes necessary. Laparotomy is the current gold standard; however a laparoscopic approach offers many potential benefits.
Methods
This institutional review board (IRB)-approved study evaluated all patients undergoing laparoscopic retroperitoneal lymph node biopsy from 2001 to 2007 at the Cleveland Clinic. Patient records were retrospectively reviewed for age, sex, pathologic diagnosis, conversion to laparotomy, and perioperative complications.
Results
A total of 30 cases were reviewed. In this group, 67% were males and 33% were female; mean age was 48 years. Ten patients underwent mesenteric lymph node sampling and 20 (67%) underwent retroperitoneal tumor resection. There were four (17%) conversions and no complications. Lymphoma was the most common pathologic finding.
Conclusion
Laparoscopic lymph node biopsy is a safe effective alternative to open surgical biopsy.
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References
Salky B, Bauer J, Gelernt I, Kreel I (1985) Laparoscopy for gastrointestinal diseases. Mt Sinai J Med 52(3):228–232
Balestreri L, Morassut S, Bernardi D et al (2005) Efficacy of CT-guided percutaneous needle biopsy in the diagnosis of malignant lymphoma at first presentation. Clin Imaging 29(2):123–127
Gupta S (2004) New techniques in image-guided percutaneous biopsy. Cardiovasc Intervent Radiol 27(2):91–104
Ojalehto M, Tikkakoski T, Rissanen T, Apaja-Sarkkinen M (2002) Ultrasound-guided percutaneous thoracoabdominal biopsy. Acta Radiol 43(2):152–158
Silverman SG, Tuncali K, Adams DF et al (1999) CT fluoroscopy-guided abdominal interventions: techniques, results, and radiation exposure. Radiology 212(3):673–681
vanSonnenberg E, Wittenberg J, Ferrucci JT Jr et al (1981) Triangulation method for percutaneous needle guidance: the angled approach to upper abdominal masses. AJR Am J Roentgenol 137(4):757–761
Bret PM, Fond A, Casola G et al (1986) Abdominal lesions: a prospective study of clinical efficacy of percutaneous fine-needle biopsy. Radiology 159(2):345–346
Steel BL, Schwartz MR, Ramzy I (1995) Fine needle aspiration biopsy in the diagnosis of lymphadenopathy in 1,103 patients. Role, limitations and analysis of diagnostic pitfalls. Acta Cytol 39(1):76–81
Asoglu O, Porter L, Donohue JH, Cha SS (2005) Laparoscopy for the definitive diagnosis of intra-abdominal lymphoma. Mayo Clin Proc 80(5):625–631
Mann GB, Conlon KC, LaQuaglia M et al (1998) Emerging role of laparoscopy in the diagnosis of lymphoma. J Clin Oncol 16(5):1909–1915
Cowles RA, Yahanda AM (2000) Laparoscopic biopsy of abdominal retroperitoneal lymphadenopathy for the diagnosis of lymphoma. J Am Coll Surg 191(1):108–113
Porte H, Copin MC, Eraldi L et al (1997) Retroperitoneoscopy for the diagnosis of infiltrating retroperitoneal lymphadenopathy and masses. Br J Surg 84(10):1433–1436
Salky BA, Bauer JJ, Gelernt IM, Kreel I (1988) The use of laparoscopy in retroperitoneal pathology. Gastrointest Endosc 34(3):227–230
Strickler JG, Donohue JH, Porter LE, Habermann TM (1998) Laparoscopic biopsy for suspected abdominal lymphoma. Mod Pathol 11(9):831–836
Bhayani SB, Allaf ME, Kavoussi LR (2004) Laparoscopic RPLND for clinical stage I nonseminomatous germ cell testicular cancer: current status. Urol Oncol 22(2):145–148
Janetschek G, Peschel R, Hobisch A, Bartsch G (2001) Laparoscopic retroperitoneal lymph node dissection. J Endourol 15(4):449–453; discussion 453–455
Nelson JB, Chen RN, Bishoff JT et al (1999) Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell testicular tumors. Urology 54(6):1064–1067
Lioe TF, Elliott H, Allen DC, Spence RA (1999) The role of fine needle aspiration cytology (FNAC) in the investigation of superficial lymphadenopathy; uses and limitations of the technique. Cytopathology 10(5):291–297
Catalano MF, Nayar R, Gress F et al (2002) EUS-guided fine needle aspiration in mediastinal lymphadenopathy of unknown etiology. Gastrointest Endosc 55(7):863–869
Milsom JW, Jerby BL, Kessler H et al (2000) Prospective, blinded comparison of laparoscopic ultrasonography vs. contrast-enhanced computerized tomography for liver assessment in patients undergoing colorectal carcinoma surgery. Dis Colon Rectum 43(1):44–49
Montorsi M, Santambrogio R, Bianchi P et al (2001) Laparoscopy with laparoscopic ultrasound for pretreatment staging of hepatocellular carcinoma: a prospective study. J Gastrointest Surg 5(3):312–315
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Diulus, L., Chalikonda, S., Pitt, T. et al. Efficacy of laparoscopic mesenteric/retroperitoneal lymph node biopsy. Surg Endosc 23, 389–393 (2009). https://doi.org/10.1007/s00464-008-9935-7
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DOI: https://doi.org/10.1007/s00464-008-9935-7