Feasibility of laparoscopic extraperitoneal pelvic lymphadenectomy in gynecologic malignancies

ObjectiveThe aim of this study is to evaluate the feasibility of laparoscopic extraperitoneal pelvic lymphadenectomy (LEPL) in gynecologic malignancies.MethodsTwenty-nine women with cervical, ovarian or endometrial cancer underwent laparoscopic extraperitoneal pelvic lymphadenectomy between July 2008 and December 2010. The operating time, nodal yield, blood loss and complications were recorded.ResultsThe number of patients with cervical, ovarian and endometrial carcinoma was 14, 3 and 12, respectively. The median age of patients was 48.9 ± 12.6 years. The median body mass index was 25.6 ± 4.8. Conversion to the transperitoneal laparoscopic approach was necessary in 6 patients for peritoneal tears causing CO2 gas leakage. Among the remaining 23 patients, the median operating time for laparoscopic extraperitoneal pelvic lymphadenectomy was 69 min (range 50–126 min), and the median estimated blood loss was 20 ml (range 5–105 ml). The median total number of resected nodes was 26 (range 14–42), and complications related to the procedure were rare.ConclusionsLaparoscopic extraperitoneal pelvic lymphadenectomy is a feasible and safe procedure. It can be used in gynecologic malignancies.

Research highlights
► LEPL was performed in 29 women with cervical, ovarian or endometrial cancer.
► LEPL is a safe procedure with rare complication and a small amount of blood loss.
► LEPL is a feasible procedure with acceptable nodal yield and short operating time.