Laparoscopic Lymphadenectomy for Isolated Lymph Node Recurrence in Gynecologic Malignancies

Study ObjectiveTo assess the feasibility and efficacy of laparoscopic lymphadenectomy in patients with isolated lymph node recurrences (ILNR) who underwent initial surgery because of gynecologic malignancy.DesignRetrospective study (Canadian Task Force classification II-3).SettingUniversity teaching hospital.PatientsSix patients with ILNR (1 cervical, 4 ovarian, and 1 peritoneal) diagnosed between March 2003 and July 2010.InterventionLaparoscopic lymphadenectomy.Measurements and Main ResultsMedian (range) patient age was 59.5 (24–70) years, and body mass index was 21.7 (21.0–24.6). There was no unplanned conversion to laparotomy. Operating time was 337.5 (200–400) minutes, hemoglobin change was 0.9 (0.4–2.6) g/dL, and hospital stay was 8.5 (5–19) days. The number of harvested lymph nodes was 20 (5–27), and of positive lymph nodes was 4 (1–24). One patient had common iliac vein laceration, with complete hemostasis achieved using intracorporeal suture. Postoperative lymphedema occurred in 1 patient, and was managed conservatively. All patients received adjuvant chemotherapy after laparoscopic lymphadenectomy.ConclusionLaparoscopic lymphadenectomy in patients with ILNR is feasible and might be an alternative therapeutic strategy.