Lymphadénectomie lomboaortique dans les cancers gynécologiques

Abstract

Achievement of aortic lymph node dissection is a prerequisite for the practice of surgical gynaecologic oncology. Aortic node dissection may be required, routinely or indicated on the basis of macroscopic enlargement of aortic, scheduled or decided preoperatively in any malignancy of the upper genital tract. It can be performed by midline laparotomy, or using laparoscopic techniques, transperitoneally or extraperitoneally. Surgical standards must be respected, including complete dissection and a defined template, extending between the lumbar ureters up to the level of the left renal vein. Adequate exposure and the use of vascular dissection technique are required. External drainage is not required. Adding an aortic lymph node dissection to a radical procedure does not add significantly to perioperative morbidity.