Ten-year experience with extraperitoneal pelvioscopy for the lymph node staging of pelvic cancers

Abstract

Background: In view of the surgical lymphadenectomy morbidity and of the low accuracy of the preoperatory radiological investigations, minimal access surgery procedures are needed to assess lymph node involvement in pelvic cancers.

Methods: Extraperitoneal pelvioscopy (EPP) is a direct vision endoscopy permitting the exploration of the retroperitoneal space of the pelvic area. Beginning 1/05/1995, 235 patients with apparently resectable tumors underwent EPP for lymph node staging of 133 bladder, 89 prostate, 12 cervix, and one endometrium cancers.

Results: Lymph node involvement was discovered in 68 cases; the absence of lymph node involvement was demonstrated in 155 cases; and there were 12 false-negative results of the procedure. The feasibility was of 98.3%. The global sensitivity and accuracy were, respectively, 85% and 94%.

Conclusion: This study demonstrates that EPP is a safe and accurate procedure to evaluate the lymph node status of pelvic cancers.