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Transabdominal cardiophrenic lymph node dissection for cytoreductive surgery in advanced ovarian cancer.
| Content Provider | Europe PMC |
|---|---|
| Author | Yang, Hee Chul Kim, Moon Soo Lee, Jong Mog Choi, Jin Ho Park, Sang-Yoon |
| Copyright Year | 2022 |
| Abstract | ObjectiveMinimizing residual tumors is one of the most important prognostic factors in the management of advanced ovarian cancer [1]. In ovarian cancer patients with cardiophrenic lymph node (LN) metastases, transabdominal cardiophrenic lymph node dissection (CPLND) has been performed along with the surgery on the primary site [2]. However, CPLND for the complicated locations in the thoracic cavity is still technically challenging. This video aims to share our surgical technique for the transabdominal CPLND.MethodsA 60-year-old woman who presented with suspicious bilateral ovarian cancer was hospitalized for cytoreductive surgery. Preoperative CT demonstrated peritoneal seeding and multiple LN metastases including right anterior, lateral, posterior, and left anterior cardiophrenic LNs. The gynecology and general surgery team underwent hysterectomy, bilateral salpingo-oophorectomy, supracolic omentectomy, lower anterior resection, right diaphragmatic and bladder peritonectomy, pelvic and paraaortic LN dissection, and appendectomy. The thoracic surgeon took over the operation because the pelvic cavity was regarded as R0. CPLND was performed by transabdominal, subxiphoid approach. The procedure is narrated in the video.ResultsComplete clearance of CPLN leaving no gross residual disease was possible without complication. A long, transverse incision of the anterior diaphragm was closed with a 1-0 polypropylene in the way of double layered continuous running suture and 8 times ties for the final knot.ConclusionTransabdominal CPLND can be used safely and effectively without change of patient's position and with minimal diaphragmatic injury. However, this approach may be unfeasible for metastatic internal mammary LN dissection and still needs meticulous surgical skills to avoid complications. |
| ISSN | 20050380 |
| Journal | Journal of Gynecologic Oncology |
| Volume Number | 33 |
| PubMed Central reference number | PMC8728674 |
| Issue Number | 1 |
| PubMed reference number | 34783209 |
| e-ISSN | 20050399 |
| DOI | 10.3802/jgo.2022.33.e6 |
| Language | English |
| Publisher | Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology; Japan Society of Gynecologic Oncology |
| Publisher Date | 2021-10-28 |
| Access Restriction | Open |
| Rights License | This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2022. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology |
| Subject Keyword | Lymph Node Ovarian Cancer VATS Pericardium |
| Content Type | Text |
| Resource Type | Article |
| Subject | Oncology Obstetrics and Gynecology |
