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Single-port laparoscopy and extraperitoneal para-aortic lymphadenectomy for locally advanced cervical cancer: assessment after 52 consecutive patients

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Abstract

Background

To report the feasibility and reproducibility of single-port extraperitoneal para-aortic (PA) lymphadenectomy exclusively using conventional instruments in locally advanced cervical cancer (LACC) and to evaluate the learning curve.

Methods

From January 2011 to January 2013, 52 a total of consecutive patients with LACC were candidates for extraperitoneal PA lymphadenectomy via an original single-port approach that we developed. All patients underwent positron emission tomography–computed tomography that indicated no PA uptake.

Results

Fifty consecutive patients underwent single-port staging surgery. Two patients had peritoneal carcinomatosis and were not submitted to PA lymphadenectomy. Median age and body mass index were, respectively 47 (range 27–68) years and 23 (range 16–37) kg/m2. In one case, lymphadenectomy was unfeasible because of renal vessel anomalies (a bifurcated left renal vein crossed the aorta at the level of the inferior mesenteric artery), and two nodes were removed. Conventional instruments were used in all cases. The median operative time was 180 (range 110–270) min. The median and mean number of nodes removed were, respectively, 18 (range 2–47) and 19.4. Six (12 %) patients had metastatic PA disease. No conversion to laparotomy or conventional multiport laparoscopy was required. The median postoperative hospital stay and the interval between staging surgery and the beginning of chemoradiation were, respectively, 2 (range 1–26) days and 16.5 (range 1–60) days. The learning curve was evaluated at seven procedures with a decreased median operative time at 160 (range 110–240) min.

Conclusions

Extraperitoneal staging via a single-port left iliac approach is feasible with conventional tools, is reproducible and safe, and offers a high degree of cosmetic satisfaction.

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Acknowledgments

We would like to thank Lorna Saint Ange for editing.

Disclosures

Drs. Sébastien Gouy, Catherine Uzan, Stéphanie Scherier, Tristan Gauthier, Enrica Bentivegna, Aminata Kane, Philippe Morice, and Frederic Marchal have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, Institut Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France

    Sébastien Gouy, Catherine Uzan, Stéphanie Scherier, Tristan Gauthier, Enrica Bentivegna, Aminata Kane & Philippe Morice

  2. University Paris Sud, Villejuif Cedex, France

    Sébastien Gouy, Catherine Uzan, Stéphanie Scherier, Tristan Gauthier, Enrica Bentivegna, Aminata Kane & Philippe Morice

  3. Centre de Recherche Automatique de Nancy (CRAN), UMR 7039, CNRS, Université de Nancy, Avenue de Bourgogne, 54511, Vandoeuvre-lès-Nancy Cedex, France

    Sébastien Gouy & Frédéric Marchal

  4. Department of Surgery, Centre Alexis-Vautrin, Vandoeuvre-lès-Nancy Cedex, France

    Frédéric Marchal

Authors
  1. Sébastien Gouy
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  2. Catherine Uzan
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  3. Stéphanie Scherier
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  4. Tristan Gauthier
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  5. Enrica Bentivegna
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  6. Aminata Kane
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  7. Philippe Morice
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  8. Frédéric Marchal
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Correspondence to Sébastien Gouy.

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Gouy, S., Uzan, C., Scherier, S. et al. Single-port laparoscopy and extraperitoneal para-aortic lymphadenectomy for locally advanced cervical cancer: assessment after 52 consecutive patients. Surg Endosc 28, 249–256 (2014). https://doi.org/10.1007/s00464-013-3180-4

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  • DOI: https://doi.org/10.1007/s00464-013-3180-4

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